Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.14 / $57.48 / $65.54	Facility	26	$41.14	$57.48	$65.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.73 / $98.49 / $325.00	Professional		$83.73	$98.49	$325.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.09 / $54.62 / $197.86	Professional	26	$36.09	$54.62	$197.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.00 / $56.22 / $131.91	Professional	TC	$41.00	$56.22	$131.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.77 / $121.97 / $135.86	Professional		$120.77	$121.97	$135.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.06 / $61.72 / $68.93	Professional	26	$41.06	$61.72	$68.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.25 / $60.25 / $60.25	Professional	TC	$60.25	$60.25	$60.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.50 / $89.33 / $99.26	Professional		$67.50	$89.33	$99.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.39 / $52.14 / $57.93	Professional	26	$39.39	$52.14	$57.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.10 / $37.20 / $41.33	Professional	TC	$28.10	$37.20	$41.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.83 / $49.29 / $90.15	Professional		$34.83	$49.29	$90.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.03 / $117.84 / $204.28	Professional		$73.03	$117.84	$204.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.99 / $53.99 / $73.43	Professional	26	$35.99	$53.99	$73.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.17 / $52.34 / $158.22	Professional	TC	$35.17	$52.34	$158.22
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $138.88 / $138.88 / $156.24	Professional		$138.88	$138.88	$156.24
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $68.22 / $70.98 / $79.27	Professional	26	$68.22	$70.98	$79.27
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $69.29 / $69.29 / $69.29	Professional	TC	$69.29	$69.29	$69.29
United Facility/Professional Professional Modifier Low / Median / High Price $68.13 / $115.89 / $203.74	Professional		$68.13	$115.89	$203.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.03 / $48.94 / $73.41	Professional	26	$36.03	$48.94	$73.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.88 / $51.56 / $119.39	Professional	TC	$29.88	$51.56	$119.39