Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.63 / $20.34 / $24.90	Facility	26	$19.63	$20.34	$24.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.64 / $52.75 / $83.80	Professional		$43.64	$52.75	$83.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $20.32 / $34.65	Professional	26	$13.58	$20.32	$34.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.49 / $34.03 / $52.40	Professional	TC	$28.49	$34.03	$52.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.63 / $67.63 / $74.12	Professional		$67.63	$67.63	$74.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $24.74 / $27.57	Professional	26	$16.48	$24.74	$27.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.52 / $42.89 / $49.86	Professional	TC	$36.52	$42.89	$49.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.48 / $62.85 / $69.83	Professional		$47.48	$62.85	$69.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.64 / $23.35 / $25.94	Professional	26	$17.64	$23.35	$25.94
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.85 / $39.50 / $43.89	Professional	TC	$29.85	$39.50	$43.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $33.94 / $56.40	Professional		$15.00	$33.94	$56.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $66.22 / $87.09	Professional		$45.00	$66.22	$87.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.65 / $22.16 / $30.02	Professional	26	$14.65	$22.16	$30.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.75 / $40.86 / $56.18	Professional	TC	$28.75	$40.86	$56.18
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $63.54 / $85.24	Professional		$63.54	$63.54	$85.24
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $24.15 / $28.45 / $32.42	Professional	26	$24.15	$28.45	$32.42
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $42.00 / $42.00 / $57.34	Professional	TC	$42.00	$42.00	$57.34
United Facility/Professional Professional Modifier Low / Median / High Price $44.45 / $49.08 / $88.03	Professional		$44.45	$49.08	$88.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.62 / $18.25 / $31.25	Professional	26	$14.62	$18.25	$31.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.57 / $32.84 / $59.11	Professional	TC	$28.57	$32.84	$59.11