Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $18.20 / $21.88	Facility	26	$18.20	$18.20	$21.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $60.26 / $134.90	Professional		$38.90	$60.26	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.88 / $33.11	Professional	26	$9.12	$12.88	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $41.69 / $100.00	Professional	TC	$30.20	$41.69	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $81.28 / $123.03	Professional		$44.67	$81.28	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $21.38 / $25.70	Professional	26	$10.23	$21.38	$25.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $57.54 / $85.11	Professional	TC	$57.54	$57.54	$85.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $56.23 / $72.44	Professional		$48.98	$56.23	$72.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $15.85 / $20.42	Professional	26	$13.80	$15.85	$20.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $40.74 / $52.48	Professional	TC	$35.48	$40.74	$52.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $50.12 / $95.50	Professional		$12.88	$50.12	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $67.61 / $112.20	Professional		$48.98	$67.61	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $19.50 / $28.18	Professional	26	$12.59	$19.50	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $48.98 / $85.11	Professional	TC	$34.67	$48.98	$85.11
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $93.33 / $109.65	Professional		$61.66	$93.33	$109.65
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $25.70 / $28.84	Professional	26	$24.55	$25.70	$28.84
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $66.07 / $97.72	Professional	TC	$66.07	$66.07	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $57.54 / $100.00	Professional		$47.86	$57.54	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $15.85 / $26.30	Professional	26	$12.59	$15.85	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $42.66 / $75.86	Professional	TC	$33.88	$42.66	$75.86