Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.22 / $84.90 / $481.50	Facility		$33.22	$84.90	$481.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.11 / $10.65 / $12.93	Facility	26	$10.11	$10.65	$12.93
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.64 / $24.14 / $139.41	Facility	TC	$22.64	$24.14	$139.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.73 / $33.22 / $54.40	Professional		$23.73	$33.22	$54.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $10.58 / $34.54	Professional	26	$7.03	$10.58	$34.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $14.58 / $14.58 / $38.72	Professional	50	$14.58	$14.58	$38.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.87 / $16.61 / $19.30	Professional	52	$11.87	$16.61	$19.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $22.64 / $40.29	Professional	TC	$17.89	$22.64	$40.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.79 / $40.13 / $46.11	Professional		$32.79	$40.13	$46.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $13.12 / $19.68	Professional	26	$6.25	$13.12	$19.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.94 / $33.50 / $40.40	Professional	TC	$26.94	$33.50	$40.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.60 / $107.60 / $117.07	Facility		$107.60	$107.60	$117.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.50 / $39.04 / $43.38	Professional		$29.50	$39.04	$43.38
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 $20.32 / $26.91 / $29.90	Professional	TC	$20.32	$26.91	$29.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.57 / $26.82 / $38.26	Facility		$7.57	$26.82	$38.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.80 / $22.85 / $35.20	Professional		$7.80	$22.85	$35.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.96 / $53.76 / $121.80	Facility		$25.96	$53.76	$121.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.51 / $38.71 / $53.84	Professional		$27.51	$38.71	$53.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $11.52 / $15.60	Professional	26	$7.61	$11.52	$15.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.37 / $37.58	Professional	TC	$18.62	$25.37	$37.58
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $37.71 / $46.15 / $59.13	Professional		$37.71	$46.15	$59.13
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $12.40 / $15.17 / $25.28	Professional	26	$12.40	$15.17	$25.28
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $30.98 / $38.53 / $67.14	Professional	TC	$30.98	$38.53	$67.14
United Facility/Professional Professional Modifier Low / Median / High Price $25.75 / $30.87 / $54.71	Professional		$25.75	$30.87	$54.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $9.52 / $15.90	Professional	26	$7.66	$9.52	$15.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.94 / $22.68 / $39.63	Professional	TC	$17.94	$22.68	$39.63