Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.58 / $80.15 / $563.98	Facility		$27.58	$80.15	$563.98
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.76 / $10.65 / $11.95	Facility	26	$9.76	$10.65	$11.95
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.01 / $24.01 / $246.50	Facility	TC	$21.01	$24.01	$246.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.80 / $33.77 / $90.00	Professional		$23.80	$33.77	$90.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $9.77 / $39.29	Professional	26	$6.71	$9.77	$39.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.74 / $15.39 / $19.05	Professional	52	$10.74	$15.39	$19.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $21.01 / $36.25	Professional	TC	$17.89	$21.01	$36.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.58 / $39.58 / $46.59	Professional		$39.58	$39.58	$46.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.06 / $11.88 / $17.47	Professional	26	$6.06	$11.88	$17.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.73 / $27.49 / $41.24	Professional	TC	$23.73	$27.49	$41.24
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 $27.39 / $36.25 / $40.28	Professional		$27.39	$36.25	$40.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.47 / $11.21 / $12.46	Professional	26	$8.47	$11.21	$12.46
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.92 / $25.04 / $27.82	Professional	TC	$18.92	$25.04	$27.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.98 / $24.14 / $34.68	Facility		$6.98	$24.14	$34.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.20 / $20.56 / $31.84	Professional		$7.20	$20.56	$31.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.45 / $53.76 / $112.48	Facility		$25.45	$53.76	$112.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.24 / $51.50	Professional		$25.12	$38.24	$51.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $10.64 / $14.42	Professional	26	$7.25	$10.64	$14.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.41 / $25.45 / $35.50	Professional	TC	$17.41	$25.45	$35.50
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $45.52 / $45.52 / $48.05	Professional		$45.52	$45.52	$48.05
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $11.56 / $13.92 / $23.35	Professional	26	$11.56	$13.92	$23.35
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $27.29 / $34.65 / $47.43	Professional	TC	$27.29	$34.65	$47.43
United Facility/Professional Professional Modifier Low / Median / High Price $24.75 / $31.56 / $50.67	Professional		$24.75	$31.56	$50.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.07 / $9.01 / $14.55	Professional	26	$7.07	$9.01	$14.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $20.81 / $36.38	Professional	TC	$17.57	$20.81	$36.38