Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $36.31 / $45.71	Facility	26	$31.62	$36.31	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $75.86 / $158.49	Professional		$47.86	$75.86	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $32.36 / $81.28	Professional	26	$21.88	$32.36	$81.28
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $53.70 / $87.10 / $354.81	Professional	52	$53.70	$87.10	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $39.81 / $95.50	Professional	TC	$25.12	$39.81	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $95.50	Professional		$32.36	$50.12	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $26.30 / $47.86	Professional	26	$20.42	$26.30	$47.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $22.91 / $53.70	Professional	TC	$22.39	$22.91	$53.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $97.72 / $125.89	Professional		$85.11	$97.72	$125.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $31.62 / $40.74	Professional	26	$27.54	$31.62	$40.74
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $66.07 / $85.11	Professional	TC	$57.54	$66.07	$85.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $31.62 / $63.10	Professional		$25.70	$31.62	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $100.00 / $144.54	Professional		$50.12	$100.00	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $35.48 / $56.23	Professional	26	$22.91	$35.48	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $58.88 / $93.33	Professional	TC	$25.12	$58.88	$93.33
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $109.65	Professional		$102.33	$102.33	$109.65
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $48.98 / $57.54	Professional	26	$13.80	$48.98	$57.54
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $61.66 / $61.66	Professional	TC	$61.66	$61.66	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $85.11 / $134.90	Professional		$67.61	$85.11	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $31.62 / $52.48	Professional	26	$25.12	$31.62	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $53.70 / $89.13	Professional	TC	$42.66	$53.70	$89.13