Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.63 / $123.00 / $282.63	Facility		$38.63	$123.00	$282.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $11.92 / $14.59	Facility	26	$7.94	$11.92	$14.59
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.71 / $31.60 / $282.63	Facility	TC	$26.71	$31.60	$282.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $38.63 / $63.95	Professional		$20.39	$38.63	$63.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.92 / $40.79	Professional	26	$7.94	$11.92	$40.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $26.71 / $50.63	Professional	TC	$20.96	$26.71	$50.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $52.52 / $58.57	Professional		$28.18	$52.52	$58.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.00 / $14.29 / $21.44	Professional	26	$8.00	$14.29	$21.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $87.85 / $87.85 / $87.85	Professional	50	$87.85	$87.85	$87.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.13 / $30.13 / $30.13	Professional	TC	$30.13	$30.13	$30.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.62 / $76.62 / $83.36	Facility		$76.62	$76.62	$83.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.76 / $40.72 / $45.24	Professional		$30.76	$40.72	$45.24
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.07 / $12.01 / $13.34	Professional	26	$9.07	$12.01	$13.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.69 / $28.71 / $31.90	Professional	TC	$21.69	$28.71	$31.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.22 / $31.04 / $43.53	Facility		$8.22	$31.04	$43.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.50 / $26.44 / $40.10	Professional		$8.50	$26.44	$40.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.96 / $100.68 / $161.54	Facility		$26.96	$100.68	$161.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $42.36 / $64.31	Professional		$30.17	$42.36	$64.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $12.54 / $16.98	Professional	26	$8.34	$12.54	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $29.77 / $46.14	Professional	TC	$21.64	$29.77	$46.14
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $58.17 / $58.17 / $60.40	Professional		$58.17	$58.17	$60.40
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.95 / $16.43 / $24.66	Professional	26	$13.95	$16.43	$24.66
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $101.03 / $101.03 / $101.03	Professional	50	$101.03	$101.03	$101.03
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $34.65 / $34.65 / $34.65	Professional	TC	$34.65	$34.65	$34.65
United Facility/Professional Professional Modifier Low / Median / High Price $30.11 / $36.06 / $63.02	Professional		$30.11	$36.06	$63.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $11.09 / $17.30	Professional	26	$8.63	$11.09	$17.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $26.27 / $45.55	Professional	TC	$20.89	$26.27	$45.55