Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $107.15 / $316.23	Facility		$33.88	$107.15	$316.23
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $11.48 / $13.49	Facility	26	$10.47	$11.48	$13.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $28.18 / $194.98	Facility	TC	$23.44	$28.18	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $28.84 / $67.61	Professional		$12.59	$28.84	$67.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.00 / $27.54	Professional	26	$6.03	$10.00	$27.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.91 / $42.66	Professional	TC	$15.85	$22.91	$42.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $25.70 / $48.98	Professional		$20.89	$25.70	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $8.91 / $14.45	Professional	26	$5.75	$8.91	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $21.88 / $40.74	Professional	TC	$16.22	$21.88	$40.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $104.71	Facility		$75.86	$75.86	$104.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $36.31 / $46.77	Professional		$31.62	$36.31	$46.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.72 / $13.80	Professional	26	$9.33	$10.72	$13.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $25.12 / $32.36	Professional	TC	$21.88	$25.12	$32.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.76 / $28.84 / $47.86	Facility		$7.76	$28.84	$47.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $25.70 / $48.98	Professional		$7.59	$25.70	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $52.48 / $162.18	Facility		$29.51	$52.48	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $40.74 / $60.26	Professional		$27.54	$40.74	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $16.60	Professional	26	$7.94	$12.02	$16.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $27.54 / $41.69	Professional	TC	$19.50	$27.54	$41.69
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $45.71 / $57.54	Professional		$36.31	$45.71	$57.54
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.80 / $17.38	Professional	26	$10.23	$13.80	$17.38
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $25.70 / $46.77	Professional	TC	$20.42	$25.70	$46.77
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $138.04 / $257.04	Facility		$107.15	$138.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $32.36 / $54.95	Professional		$27.54	$32.36	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.33 / $15.85	Professional	26	$7.59	$9.33	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $22.91 / $40.74	Professional	TC	$19.50	$22.91	$40.74