Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $8.91 / $10.72	Facility	26	$7.94	$8.91	$10.72
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.18 / $33.11 / $194.98	Facility	TC	$28.18	$33.11	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $38.90 / $112.20	Professional		$14.79	$38.90	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $9.33 / $22.91	Professional	26	$5.01	$9.33	$22.91
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $12.30 / $104.71 / $181.97	Professional	50	$12.30	$104.71	$181.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $50.12 / $50.12 / $50.12	Professional	52	$50.12	$50.12	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.20 / $64.57	Professional	TC	$20.42	$30.20	$64.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $35.48 / $61.66	Professional		$23.99	$35.48	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $7.08 / $11.48	Professional	26	$5.01	$7.08	$11.48
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $43.65 / $63.10	Professional	50	$38.02	$43.65	$63.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $32.36 / $52.48	Professional	TC	$23.99	$32.36	$52.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $38.90 / $50.12	Professional		$33.88	$38.90	$50.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $8.71 / $11.22	Professional	26	$7.59	$8.71	$11.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.20 / $38.90	Professional	TC	$26.30	$30.20	$38.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.46 / $32.36 / $63.10	Professional		$6.46	$32.36	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.02 / $66.07	Professional		$25.12	$38.02	$66.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $9.55 / $13.49	Professional	26	$6.31	$9.55	$13.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $28.84 / $52.48	Professional	TC	$18.62	$28.84	$52.48
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $64.57 / $72.44	Professional		$38.02	$64.57	$72.44
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $12.30 / $14.13	Professional	26	$5.50	$12.30	$14.13
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	50	$44.67	$44.67	$44.67
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $44.67 / $60.26	Professional	TC	$29.51	$44.67	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $35.48 / $61.66	Professional		$25.12	$35.48	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.41 / $13.18	Professional	26	$6.17	$7.41	$13.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.18 / $50.12	Professional	TC	$20.42	$28.18	$50.12