Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.01 / $18.01 / $22.03	Facility	26	$18.01	$18.01	$22.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $60.58 / $115.98	Professional		$46.93	$60.58	$115.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $14.77 / $22.91	Professional	26	$11.32	$14.77	$22.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $42.57 / $99.09	Professional	TC	$34.14	$42.57	$99.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.26 / $80.26 / $80.26	Professional		$80.26	$80.26	$80.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.02 / $20.98 / $20.98	Professional	26	$15.02	$20.98	$20.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.35 / $65.31 / $72.56	Professional		$49.35	$65.31	$72.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.87 / $18.36 / $20.39	Professional	26	$13.87	$18.36	$20.39
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.47 / $46.95 / $52.17	Professional	TC	$35.47	$46.95	$52.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.98 / $46.33 / $68.18	Professional		$12.98	$46.33	$68.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.41 / $67.73 / $102.82	Professional		$49.41	$67.73	$102.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.50 / $19.30 / $25.84	Professional	26	$12.50	$19.30	$25.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.34 / $48.68 / $75.19	Professional	TC	$35.34	$48.68	$75.19
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $92.30 / $92.30 / $92.30	Professional		$92.30	$92.30	$92.30
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $17.27 / $24.61 / $28.04	Professional	26	$17.27	$24.61	$28.04
United Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $59.76 / $101.99	Professional		$47.97	$59.76	$101.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $15.90 / $25.88	Professional	26	$12.96	$15.90	$25.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.47 / $43.00 / $76.66	Professional	TC	$30.47	$43.00	$76.66