Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $41.69 / $48.98	Facility	26	$37.15	$41.69	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $70.79 / $134.90	Professional		$53.70	$70.79	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $28.18 / $54.95	Professional	26	$19.95	$28.18	$54.95
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $213.80 / $257.04	Professional	50	$66.07	$213.80	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.90 / $57.54	Professional	TC	$23.99	$38.90	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $102.33	Professional		$44.67	$50.12	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $19.95 / $47.86	Professional	26	$19.95	$19.95	$47.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $33.88 / $33.88	Professional	TC	$33.88	$33.88	$33.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $70.79 / $91.20	Professional		$61.66	$70.79	$91.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $35.48 / $45.71	Professional	26	$30.90	$35.48	$45.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $36.31 / $45.71	Professional	TC	$31.62	$36.31	$45.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $31.62 / $63.10	Professional		$27.54	$31.62	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $100.00 / $138.04	Professional		$60.26	$100.00	$138.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $38.90 / $60.26	Professional	26	$25.70	$38.90	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $52.48 / $74.13	Professional	TC	$30.90	$52.48	$74.13
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $117.49	Professional		$70.79	$70.79	$117.49
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	26	$54.95	$54.95	$54.95
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $38.90 / $38.90	Professional	TC	$38.90	$38.90	$38.90
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $77.62 / $128.82	Professional		$57.54	$77.62	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.88 / $56.23	Professional	26	$26.92	$33.88	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $43.65 / $75.86	Professional	TC	$31.62	$43.65	$75.86