Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.70 / $14.31 / $16.85	Facility	26	$12.70	$14.31	$16.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.92 / $73.34 / $300.00	Professional		$31.92	$73.34	$300.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.97 / $14.28 / $51.30	Professional	26	$8.97	$14.28	$51.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.62 / $56.50 / $119.70	Professional	TC	$17.62	$56.50	$119.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.75 / $38.24 / $38.61	Professional		$28.75	$38.24	$38.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.72 / $14.85 / $15.39	Professional	26	$7.72	$14.85	$15.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.17 / $23.39 / $23.39	Professional	TC	$12.17	$23.39	$23.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.28 / $29.49 / $32.77	Professional		$22.28	$29.49	$32.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.14 / $13.42 / $14.91	Professional	26	$10.14	$13.42	$14.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.14 / $16.07 / $17.86	Professional	TC	$12.14	$16.07	$17.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.18 / $16.00 / $28.99	Professional		$9.18	$16.00	$28.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.92 / $40.15 / $162.66	Professional		$25.92	$40.15	$162.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $13.46 / $18.38	Professional	26	$9.00	$13.46	$18.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.36 / $22.42 / $151.72	Professional	TC	$14.36	$22.42	$151.72
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $33.06 / $43.98 / $44.41	Professional		$33.06	$43.98	$44.41
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $8.88 / $17.07 / $17.70	Professional	26	$8.88	$17.07	$17.70
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $14.00 / $26.90 / $26.90	Professional	TC	$14.00	$26.90	$26.90
United Facility/Professional Professional Modifier Low / Median / High Price $20.92 / $38.83 / $150.07	Professional		$20.92	$38.83	$150.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $11.97 / $18.36	Professional	26	$9.02	$11.97	$18.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.28 / $21.39 / $85.26	Professional	TC	$12.28	$21.39	$85.26