Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.94 / $18.95 / $23.18	Facility	26	$18.94	$18.95	$23.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.50 / $38.50 / $57.89	Facility	TC	$38.50	$38.50	$57.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $57.45 / $96.98	Professional		$44.27	$57.45	$96.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $15.43 / $25.78	Professional	26	$12.20	$15.43	$25.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $75.00 / $75.00 / $75.00	Professional	50	$75.00	$75.00	$75.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.75 / $38.50 / $61.60	Professional	TC	$30.75	$38.50	$61.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.70 / $89.05 / $89.05	Professional		$42.70	$89.05	$89.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.94 / $23.20 / $25.90	Professional	26	$12.94	$23.20	$25.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.23 / $52.23 / $59.89	Professional	TC	$52.23	$52.23	$59.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.24 / $61.20 / $68.00	Professional		$46.24	$61.20	$68.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $19.76 / $21.96	Professional	26	$14.93	$19.76	$21.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.31 / $41.44 / $46.04	Professional	TC	$31.31	$41.44	$46.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.79 / $39.15 / $60.95	Professional		$13.79	$39.15	$60.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.76 / $63.46 / $96.56	Professional		$45.76	$63.46	$96.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.46 / $20.57 / $27.81	Professional	26	$13.46	$20.57	$27.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.93 / $42.97 / $67.93	Professional	TC	$31.93	$42.97	$67.93
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $102.41 / $102.41 / $102.41	Professional		$102.41	$102.41	$102.41
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $18.12 / $26.15 / $29.79	Professional	26	$18.12	$26.15	$29.79
United Facility/Professional Professional Modifier Low / Median / High Price $45.39 / $55.34 / $93.79	Professional		$45.39	$55.34	$93.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $17.25 / $27.86	Professional	26	$13.70	$17.25	$27.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.77 / $38.54 / $67.61	Professional	TC	$30.77	$38.54	$67.61