Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $141.25 / $288.40	Facility		$32.36	$141.25	$288.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $11.48 / $14.13	Facility	26	$10.96	$11.48	$14.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $30.90 / $309.03	Facility	TC	$20.42	$30.90	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $32.36 / $91.20	Professional		$21.38	$32.36	$91.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.12 / $30.20	Professional	26	$7.08	$9.12	$30.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $51.29	Professional	TC	$15.14	$21.88	$51.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $24.55 / $45.71	Professional		$19.05	$24.55	$45.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.91 / $15.14	Professional	26	$6.46	$8.91	$15.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $19.95 / $33.11	Professional	TC	$15.85	$19.95	$33.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $104.71	Facility		$75.86	$75.86	$104.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $30.90 / $39.81	Professional		$26.92	$30.90	$39.81
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.72 / $13.80	Professional	26	$9.33	$10.72	$13.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $20.42 / $26.30	Professional	TC	$17.78	$20.42	$26.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $26.92 / $44.67	Facility		$8.71	$26.92	$44.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $22.39 / $43.65	Professional		$8.51	$22.39	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $107.15 / $229.09	Facility		$20.89	$107.15	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $36.31 / $56.23	Professional		$25.70	$36.31	$56.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.59 / $18.62	Professional	26	$8.32	$12.59	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.44 / $38.90	Professional	TC	$16.98	$23.44	$38.90
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $45.71 / $58.88	Professional		$33.88	$45.71	$58.88
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.22 / $19.05	Professional	26	$10.96	$16.22	$19.05
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.20 / $38.02	Professional	TC	$21.38	$30.20	$38.02
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $138.04 / $257.04	Facility		$107.15	$138.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $30.20 / $52.48	Professional		$25.70	$30.20	$52.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.23 / $17.38	Professional	26	$8.13	$10.23	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $20.42 / $35.48	Professional	TC	$16.60	$20.42	$35.48