Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.19 / $14.93 / $17.92	Facility	26	$14.19	$14.93	$17.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.40 / $44.46 / $386.08	Facility	TC	$32.40	$44.46	$386.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.81 / $53.43 / $139.50	Professional		$30.81	$53.43	$139.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $14.19 / $49.12	Professional	26	$10.02	$14.19	$49.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.28 / $145.07 / $198.00	Professional	50	$40.28	$145.07	$198.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.60 / $23.30 / $26.96	Professional	52	$17.60	$23.30	$26.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $34.14 / $82.45	Professional	TC	$27.87	$34.14	$82.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $61.58 / $69.68	Professional		$32.11	$61.58	$69.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.26 / $18.13 / $20.23	Professional	26	$8.26	$18.13	$20.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $42.89 / $42.89 / $52.27	Professional	TC	$42.89	$42.89	$52.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.43 / $57.48 / $63.87	Professional		$43.43	$57.48	$63.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.67 / $16.77 / $18.63	Professional	26	$12.67	$16.77	$18.63
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.76 / $40.72 / $45.24	Professional	TC	$30.76	$40.72	$45.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.77 / $35.57 / $53.28	Professional		$10.77	$35.57	$53.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.15 / $53.21 / $78.01	Professional		$38.15	$53.21	$78.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $16.18 / $21.55	Professional	26	$10.55	$16.18	$21.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.49 / $36.22 / $56.18	Professional	TC	$26.49	$36.22	$56.18
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $70.81 / $70.81 / $70.81	Professional		$70.81	$70.81	$70.81
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $14.33 / $21.51 / $30.04	Professional	26	$14.33	$21.51	$30.04
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $49.32 / $49.32 / $60.11	Professional	TC	$49.32	$49.32	$60.11
United Facility/Professional Professional Modifier Low / Median / High Price $36.46 / $46.67 / $79.90	Professional		$36.46	$46.67	$79.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $13.10 / $22.07	Professional	26	$10.61	$13.10	$22.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.34 / $33.71 / $59.11	Professional	TC	$25.34	$33.71	$59.11