Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.71 / $111.25 / $365.40	Facility		$34.71	$111.25	$365.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.11 / $10.58 / $12.93	Facility	26	$10.11	$10.58	$12.93
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.79 / $29.54 / $279.88	Facility	TC	$19.79	$29.54	$279.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.64 / $33.42 / $92.70	Professional		$20.64	$33.42	$92.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $11.72 / $35.79	Professional	26	$7.03	$11.72	$35.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $20.94 / $36.33	Professional	TC	$18.21	$20.94	$36.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.58 / $43.22 / $43.65	Professional		$39.58	$43.22	$43.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $12.37 / $14.09	Professional	26	$5.75	$12.37	$14.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.56 / $26.39 / $26.39	Professional	TC	$21.56	$26.39	$26.39
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 $28.44 / $37.65 / $41.83	Professional		$28.44	$37.65	$41.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.17 / $12.13 / $13.48	Professional	26	$9.17	$12.13	$13.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.28 / $25.52 / $28.35	Professional	TC	$19.28	$25.52	$28.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.28 / $24.91 / $35.86	Facility		$7.28	$24.91	$35.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.50 / $21.22 / $32.96	Professional		$7.50	$21.22	$32.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.74 / $53.76 / $112.48	Facility		$26.74	$53.76	$112.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.37 / $39.24 / $51.36	Professional		$26.37	$39.24	$51.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $11.52 / $15.53	Professional	26	$7.38	$11.52	$15.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.96 / $24.94 / $35.10	Professional	TC	$17.96	$24.94	$35.10
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $45.52 / $49.70 / $50.20	Professional		$45.52	$49.70	$50.20
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $14.51 / $16.20	Professional	26	$10.11	$14.51	$16.20
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $24.79 / $30.35 / $30.35	Professional	TC	$24.79	$30.35	$30.35
United Facility/Professional Professional Modifier Low / Median / High Price $26.10 / $30.82 / $50.76	Professional		$26.10	$30.82	$50.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $9.76 / $15.51	Professional	26	$7.66	$9.76	$15.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $21.06 / $37.02	Professional	TC	$17.89	$21.06	$37.02