Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.67 / $25.02 / $72.44	Facility	26	$21.67	$25.02	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.42 / $145.06 / $323.38	Professional		$84.42	$145.06	$323.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.71 / $21.96 / $69.62	Professional	26	$15.71	$21.96	$69.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.52 / $129.36 / $299.19	Professional	TC	$44.52	$129.36	$299.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $145.94 / $145.94 / $145.94	Professional		$145.94	$145.94	$145.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.00 / $83.68 / $83.68	Professional	26	$39.00	$83.68	$83.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.54 / $110.57 / $122.86	Professional		$83.54	$110.57	$122.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.78 / $24.86 / $27.62	Professional	26	$18.78	$24.86	$27.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.76 / $85.72 / $95.24	Professional	TC	$64.76	$85.72	$95.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.12 / $60.18 / $108.76	Professional		$42.12	$60.18	$108.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.05 / $154.94 / $754.85	Professional		$88.05	$154.94	$754.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.52 / $27.82 / $77.70	Professional	26	$18.52	$27.82	$77.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.72 / $102.68 / $569.17	Professional	TC	$57.72	$102.68	$569.17
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $167.84 / $167.84 / $167.84	Professional		$167.84	$167.84	$167.84
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $48.30 / $96.23 / $96.23	Professional	26	$48.30	$96.23	$96.23
United Facility/Professional Professional Modifier Low / Median / High Price $95.45 / $158.62 / $579.27	Professional		$95.45	$158.62	$579.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.35 / $46.82 / $89.64	Professional	26	$18.35	$46.82	$89.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.91 / $91.91 / $485.48	Professional	TC	$53.91	$91.91	$485.48