Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $12.88 / $13.18	Facility	26	$10.00	$12.88	$13.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $22.39 / $31.62	Facility	TC	$21.88	$22.39	$31.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $25.70 / $39.81	Professional		$19.05	$25.70	$39.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.13 / $7.08 / $19.05	Professional	26	$5.13	$7.08	$19.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $18.20 / $25.12	Professional	TC	$14.13	$18.20	$25.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $22.39 / $44.67	Professional		$21.38	$22.39	$44.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $7.59 / $13.49	Professional	26	$6.31	$7.59	$13.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.30 / $32.36	Professional	TC	$17.78	$26.30	$32.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $30.20 / $38.90	Professional		$26.30	$30.20	$38.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.55 / $12.30	Professional	26	$8.32	$9.55	$12.30
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $20.42 / $26.30	Professional	TC	$17.78	$20.42	$26.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $36.31 / $54.95	Professional		$25.12	$36.31	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.48 / $17.38	Professional	26	$7.59	$11.48	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $24.55 / $38.90	Professional	TC	$17.38	$24.55	$38.90
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Professional		$51.29	$51.29	$51.29
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $15.14 / $16.22	Professional	26	$14.79	$15.14	$16.22
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $30.20 / $37.15	Professional	TC	$30.20	$30.20	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $30.20 / $51.29	Professional		$25.70	$30.20	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.33 / $15.85	Professional	26	$7.59	$9.33	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $20.89 / $36.31	Professional	TC	$17.78	$20.89	$36.31