Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.33 / $251.97 / $356.16	Facility		$41.33	$251.97	$356.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.56 / $11.61 / $13.52	Facility	26	$10.56	$11.61	$13.52
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.89 / $190.35 / $459.28	Facility	TC	$25.89	$190.35	$459.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.00 / $37.85 / $92.98	Professional		$17.00	$37.85	$92.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $11.05 / $37.24	Professional	26	$7.33	$11.05	$37.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.14 / $79.14 / $178.00	Professional	50	$79.14	$79.14	$178.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.97 / $26.62 / $45.59	Professional	TC	$20.97	$26.62	$45.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.83 / $48.38 / $53.65	Professional		$25.83	$48.38	$53.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.53 / $13.45 / $15.30	Professional	26	$6.53	$13.45	$15.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.21 / $34.09 / $34.09	Professional	TC	$29.21	$34.09	$34.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.62 / $76.62 / $83.36	Facility		$76.62	$76.62	$83.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.26 / $40.04 / $44.50	Professional		$30.26	$40.04	$44.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $12.66 / $14.07	Professional	26	$9.57	$12.66	$14.07
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.69 / $27.39 / $30.43	Professional	TC	$20.69	$27.39	$30.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.90 / $27.97 / $39.90	Facility		$7.90	$27.97	$39.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.14 / $23.83 / $36.71	Professional		$8.14	$23.83	$36.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.29 / $53.76 / $112.48	Facility		$30.29	$53.76	$112.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.62 / $44.46 / $55.18	Professional		$29.62	$44.46	$55.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $12.03 / $16.30	Professional	26	$8.01	$12.03	$16.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.61 / $29.60 / $38.20	Professional	TC	$21.61	$29.60	$38.20
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $45.46 / $55.64 / $61.70	Professional		$45.46	$55.64	$61.70
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.12 / $15.47 / $17.60	Professional	26	$13.12	$15.47	$17.60
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $33.59 / $39.20 / $39.20	Professional	TC	$33.59	$39.20	$39.20
United Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $33.38 / $57.88	Professional		$28.61	$33.38	$57.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.00 / $10.05 / $16.46	Professional	26	$8.00	$10.05	$16.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.17 / $24.35 / $40.28	Professional	TC	$21.17	$24.35	$40.28