Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.63 / $126.60 / $336.57	Facility		$33.63	$126.60	$336.57
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.56 / $11.61 / $15.69	Facility	26	$10.56	$11.61	$15.69
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.05 / $29.54 / $254.69	Facility	TC	$23.05	$29.54	$254.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.27 / $37.24 / $99.00	Professional		$21.27	$37.24	$99.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.32 / $11.06 / $42.45	Professional	26	$7.32	$11.06	$42.45
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $112.62 / $259.50 / $259.50	Professional	50	$112.62	$259.50	$259.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $23.05 / $40.79	Professional	TC	$17.57	$23.05	$40.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.24 / $40.68 / $51.95	Professional		$33.24	$40.68	$51.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.01 / $12.13 / $13.74	Professional	26	$6.01	$12.13	$13.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.94 / $26.94 / $34.46	Professional	TC	$26.94	$26.94	$34.46
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 $9.08 / $12.02 / $13.36	Professional	26	$9.08	$12.02	$13.36
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.68 / $28.69 / $31.88	Professional	TC	$21.68	$28.69	$31.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.28 / $27.59 / $38.65	Facility		$7.28	$27.59	$38.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.50 / $23.51 / $35.56	Professional		$7.50	$23.51	$35.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.74 / $53.76 / $112.48	Facility		$26.74	$53.76	$112.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.56 / $38.75 / $56.00	Professional		$27.56	$38.75	$56.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $11.99 / $15.64	Professional	26	$7.86	$11.99	$15.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.28 / $25.76 / $38.82	Professional	TC	$18.28	$25.76	$38.82
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $46.78 / $53.58 / $59.74	Professional		$46.78	$53.58	$59.74
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.51 / $16.20	Professional	26	$12.59	$14.51	$16.20
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $29.92 / $39.63 / $41.24	Professional	TC	$29.92	$39.63	$41.24
United Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $32.68 / $55.86	Professional		$26.52	$32.68	$55.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $9.39 / $15.44	Professional	26	$7.61	$9.39	$15.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.94 / $23.29 / $40.45	Professional	TC	$17.94	$23.29	$40.45