Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.85 / $103.80 / $312.39	Facility		$34.85	$103.80	$312.39
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.58 / $11.55 / $14.40	Facility	26	$10.58	$11.55	$14.40
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.25 / $24.27 / $135.36	Facility	TC	$24.25	$24.27	$135.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.48 / $34.85 / $70.70	Professional		$24.48	$34.85	$70.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.97 / $10.02 / $19.20	Professional	26	$6.97	$10.02	$19.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.24 / $17.43 / $19.30	Professional	52	$12.24	$17.43	$19.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $24.27 / $43.35	Professional	TC	$18.53	$24.27	$43.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.78 / $41.78 / $41.78	Professional		$41.78	$41.78	$41.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.37 / $14.09	Professional	26	$7.08	$12.37	$14.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.60 / $28.60 / $41.08	Professional	TC	$28.60	$28.60	$41.08
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 $31.27 / $41.39 / $45.99	Professional		$31.27	$41.39	$45.99
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.17 / $12.13 / $13.48	Professional	26	$9.17	$12.13	$13.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.11 / $29.26 / $32.51	Professional	TC	$22.11	$29.26	$32.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.28 / $27.97 / $39.04	Facility		$7.28	$27.97	$39.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.50 / $23.83 / $35.94	Professional		$7.50	$23.83	$35.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.96 / $53.76 / $112.48	Facility		$25.96	$53.76	$112.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.73 / $39.65 / $56.32	Professional		$27.73	$39.65	$56.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $11.52 / $15.60	Professional	26	$7.61	$11.52	$15.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.09 / $27.05 / $40.06	Professional	TC	$19.09	$27.05	$40.06
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $48.05 / $48.05 / $48.05	Professional		$48.05	$48.05	$48.05
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $12.40 / $14.51 / $20.93	Professional	26	$12.40	$14.51	$20.93
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $32.89 / $41.81 / $47.24	Professional	TC	$32.89	$41.81	$47.24
United Facility/Professional Professional Modifier Low / Median / High Price $25.75 / $33.79 / $59.78	Professional		$25.75	$33.79	$59.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $9.76 / $15.75	Professional	26	$7.66	$9.76	$15.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.94 / $23.66 / $41.60	Professional	TC	$17.94	$23.66	$41.60