Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $18.20 / $109.65	Facility		$16.22	$18.20	$109.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $12.59 / $15.14	Facility	26	$11.75	$12.59	$15.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $13.18 / $33.88	Professional		$8.91	$13.18	$33.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.13 / $26.30	Professional	26	$6.03	$8.13	$26.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.00 / $3.02 / $6.31	Professional	TC	$2.00	$3.02	$6.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $9.55 / $14.79	Professional		$7.94	$9.55	$14.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.45 / $14.45	Professional	26	$14.45	$14.45	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.02 / $3.02	Professional	TC	$3.02	$3.02	$3.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $30.20	Facility		$21.88	$21.88	$30.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $13.80 / $17.78	Professional		$12.02	$13.80	$17.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.12 / $11.75	Professional	26	$7.94	$9.12	$11.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $4.07 / $4.68 / $6.03	Professional	TC	$4.07	$4.68	$6.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.24 / $7.59 / $11.75	Facility		$3.24	$7.59	$11.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.16 / $7.76 / $17.38	Professional		$3.16	$7.76	$17.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4.37 / $19.50 / $46.77	Facility		$4.37	$19.50	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $16.98 / $22.91	Professional		$9.77	$16.98	$22.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $11.75 / $16.22	Professional	26	$6.76	$11.75	$16.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.34 / $4.68 / $7.24	Professional	TC	$2.34	$4.68	$7.24
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $20.42	Professional		$20.42	$20.42	$20.42
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Professional	26	$16.60	$16.60	$16.60
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $45.71 / $85.11	Facility		$35.48	$45.71	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $13.49 / $21.88	Professional		$10.47	$13.49	$21.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $9.33 / $15.85	Professional	26	$7.24	$9.33	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.16 / $3.98 / $7.24	Professional	TC	$3.16	$3.98	$7.24