Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $41.69 / $43.65	Facility	26	$30.20	$41.69	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $120.23 / $275.42	Professional		$70.79	$120.23	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.11 / $70.79	Professional	26	$25.12	$33.11	$70.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $79.43 / $218.78	Professional	TC	$41.69	$79.43	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $44.67 / $51.29	Professional	26	$20.89	$44.67	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $114.82 / $144.54	Professional		$100.00	$114.82	$144.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $33.88 / $43.65	Professional	26	$29.51	$33.88	$43.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $79.43 / $102.33	Professional	TC	$69.18	$79.43	$102.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $79.43 / $151.36	Professional		$26.92	$79.43	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $204.17	Professional		$87.10	$134.90	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $38.90 / $61.66	Professional	26	$25.70	$38.90	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $91.20 / $147.91	Professional	TC	$61.66	$91.20	$147.91
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $52.48 / $64.57	Professional	26	$34.67	$52.48	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $181.97	Professional		$87.10	$107.15	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $30.90 / $53.70	Professional	26	$25.12	$30.90	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $77.62 / $131.83	Professional	TC	$61.66	$77.62	$131.83