Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.66 / $14.66 / $33.47	Facility	26	$14.66	$14.66	$33.47
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.67 / $37.01 / $438.24	Facility	TC	$24.67	$37.01	$438.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.19 / $39.33 / $106.20	Professional		$30.19	$39.33	$106.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $14.66 / $51.95	Professional	26	$10.11	$14.66	$51.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $24.67 / $43.18	Professional	TC	$19.89	$24.67	$43.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.41 / $51.68 / $62.31	Professional		$29.41	$51.68	$62.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.19 / $18.14 / $19.51	Professional	26	$8.19	$18.14	$19.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $37.35 / $39.59	Professional	TC	$19.43	$37.35	$39.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.36 / $44.15 / $49.06	Professional		$33.36	$44.15	$49.06
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.93 / $15.80 / $17.55	Professional	26	$11.93	$15.80	$17.55
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.43 / $28.36 / $31.51	Professional	TC	$21.43	$28.36	$31.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.82 / $25.46 / $41.75	Professional		$10.82	$25.46	$41.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.44 / $44.30 / $65.84	Professional		$31.44	$44.30	$65.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.30 / $15.84 / $21.65	Professional	26	$10.30	$15.84	$21.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.67 / $28.45 / $44.43	Professional	TC	$20.67	$28.45	$44.43
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $49.35 / $63.07 / $71.66	Professional		$49.35	$63.07	$71.66
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $20.52 / $23.37	Professional	26	$17.05	$20.52	$23.37
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $22.34 / $32.02 / $45.53	Professional	TC	$22.34	$32.02	$45.53
United Facility/Professional Professional Modifier Low / Median / High Price $31.24 / $38.69 / $65.17	Professional		$31.24	$38.69	$65.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.95 / $13.54 / $21.86	Professional	26	$10.95	$13.54	$21.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.91 / $25.27 / $44.17	Professional	TC	$19.91	$25.27	$44.17