Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.65 / $30.89 / $41.53	Facility	26	$28.65	$30.89	$41.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $103.87 / $161.44	Professional		$81.68	$103.87	$161.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $29.18 / $73.95	Professional	26	$19.89	$29.18	$73.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.74 / $74.70 / $113.72	Professional	TC	$56.74	$74.70	$113.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.13 / $82.13 / $82.13	Professional		$82.13	$82.13	$82.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.19 / $36.29 / $52.32	Professional	26	$24.19	$36.29	$52.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $131.19 / $145.78	Professional		$99.13	$131.19	$145.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.84 / $48.75 / $54.17	Professional	26	$36.84	$48.75	$54.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.29 / $82.45 / $91.61	Professional	TC	$62.29	$82.45	$91.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.85 / $66.23 / $108.55	Professional		$27.85	$66.23	$108.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.50 / $110.00 / $173.16	Professional		$77.50	$110.00	$173.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.10 / $34.54 / $59.12	Professional	26	$24.10	$34.54	$59.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.71 / $77.66 / $115.08	Professional	TC	$50.71	$77.66	$115.08
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $27.82 / $51.78 / $60.17	Professional	26	$27.82	$51.78	$60.17
United Facility/Professional Professional Modifier Low / Median / High Price $77.70 / $97.80 / $175.02	Professional		$77.70	$97.80	$175.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.18 / $33.40 / $55.22	Professional	26	$23.18	$33.40	$55.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.52 / $67.12 / $117.34	Professional	TC	$54.52	$67.12	$117.34