Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.46 / $168.00 / $490.37	Facility		$50.46	$168.00	$490.37
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.18 / $14.19 / $17.87	Facility	26	$14.18	$14.19	$17.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.96 / $29.96 / $390.00	Facility	TC	$29.96	$29.96	$390.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $44.15 / $121.55	Professional		$35.95	$44.15	$121.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $14.19 / $28.78	Professional	26	$9.78	$14.19	$28.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $29.96 / $57.56	Professional	TC	$25.57	$29.96	$57.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.02 / $61.02 / $61.58	Professional		$61.02	$61.02	$61.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.88 / $16.93 / $19.67	Professional	26	$7.88	$16.93	$19.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $43.44 / $43.44 / $45.86	Professional	TC	$43.44	$43.44	$45.86
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 $35.43 / $46.90 / $52.11	Professional		$35.43	$46.90	$52.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.18 / $14.80 / $16.44	Professional	26	$11.18	$14.80	$16.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.26 / $32.10 / $35.67	Professional	TC	$24.26	$32.10	$35.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.10 / $35.25 / $50.50	Facility		$10.10	$35.25	$50.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.48 / $30.03 / $46.56	Professional		$10.48	$30.03	$46.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.62 / $121.80 / $222.46	Facility		$30.62	$121.80	$222.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.42 / $48.99 / $75.22	Professional		$36.42	$48.99	$75.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.25 / $15.46 / $20.96	Professional	26	$10.25	$15.46	$20.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.43 / $33.53 / $52.32	Professional	TC	$25.43	$33.53	$52.32
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $70.17 / $70.17 / $70.81	Professional		$70.17	$70.17	$70.81
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.92 / $19.86 / $22.62	Professional	26	$13.92	$19.86	$22.62
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $49.96 / $50.69 / $52.74	Professional	TC	$49.96	$50.69	$52.74
United Facility/Professional Professional Modifier Low / Median / High Price $35.60 / $44.46 / $72.76	Professional		$35.60	$44.46	$72.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.63 / $12.91 / $21.16	Professional	26	$10.63	$12.91	$21.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.68 / $28.87 / $51.97	Professional	TC	$24.68	$28.87	$51.97