Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $9.33 / $10.23	Facility	26	$7.94	$9.33	$10.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.99 / $28.18 / $131.83	Facility	TC	$23.99	$28.18	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $30.90 / $141.25	Professional		$18.20	$30.90	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $8.32 / $20.89	Professional	26	$5.01	$8.32	$20.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.99 / $53.70	Professional	TC	$15.85	$23.99	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $36.31 / $50.12	Professional		$19.05	$36.31	$50.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.79 / $6.03 / $10.96	Professional	26	$4.79	$6.03	$10.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $22.91 / $35.48	Professional	TC	$17.38	$22.91	$35.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.11 / $42.66	Professional		$28.84	$33.11	$42.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $8.32 / $10.72	Professional	26	$7.24	$8.32	$10.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $25.12 / $31.62	Professional	TC	$21.88	$25.12	$31.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $23.99 / $45.71	Professional		$6.17	$23.99	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $35.48 / $54.95	Professional		$23.99	$35.48	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $9.12 / $12.88	Professional	26	$6.17	$9.12	$12.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.12 / $42.66	Professional	TC	$17.38	$25.12	$42.66
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $48.98 / $51.29	Professional		$41.69	$48.98	$51.29
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $13.18	Professional	26	$8.51	$11.48	$13.18
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $31.62 / $43.65	Professional	TC	$25.70	$31.62	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $28.84 / $50.12	Professional		$23.99	$28.84	$50.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $7.41 / $12.59	Professional	26	$6.03	$7.41	$12.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.39 / $37.15	Professional	TC	$18.20	$22.39	$37.15