Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.79 / $17.78	Facility	26	$14.13	$14.79	$17.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $38.90 / $380.19	Facility	TC	$32.36	$38.90	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $48.98 / $141.25	Professional		$18.62	$48.98	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $16.60 / $43.65	Professional	26	$8.91	$16.60	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $21.38 / $87.10 / $199.53	Professional	50	$21.38	$87.10	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $77.62	Professional	TC	$25.70	$36.31	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $39.81 / $74.13	Professional		$32.36	$39.81	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.77 / $20.42	Professional	26	$8.32	$9.77	$20.42
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $61.66 / $128.82	Professional	50	$43.65	$61.66	$128.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $47.86 / $66.07	Professional	TC	$25.70	$47.86	$66.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $50.12 / $64.57	Professional		$43.65	$50.12	$64.57
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.45 / $18.62	Professional	26	$12.59	$14.45	$18.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $35.48 / $45.71	Professional	TC	$30.90	$35.48	$45.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $38.02 / $72.44	Professional		$10.72	$38.02	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $52.48 / $87.10	Professional		$37.15	$52.48	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.85 / $22.39	Professional	26	$10.47	$15.85	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $36.31 / $61.66	Professional	TC	$25.12	$36.31	$61.66
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $91.20	Professional		$57.54	$72.44	$91.20
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $20.42 / $30.20	Professional	26	$17.38	$20.42	$30.20
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $109.65 / $138.04	Professional	50	$48.98	$109.65	$138.04
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $56.23 / $70.79	Professional	TC	$28.18	$56.23	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $44.67 / $75.86	Professional		$36.31	$44.67	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.59 / $21.88	Professional	26	$10.23	$12.59	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.11 / $56.23	Professional	TC	$25.12	$33.11	$56.23