Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.85 / $36.39 / $43.27	Facility	26	$33.85	$36.39	$43.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.25 / $88.15 / $123.48	Professional		$51.25	$88.15	$123.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $34.19 / $92.65	Professional	26	$23.46	$34.19	$92.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.73 / $45.43 / $53.02	Professional	52	$22.73	$45.43	$53.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.08 / $55.88 / $71.86	Professional	TC	$26.08	$55.88	$71.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.67 / $87.59 / $91.13	Professional		$50.67	$87.59	$91.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.76 / $42.89 / $47.98	Professional	26	$10.76	$42.89	$47.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.36 / $112.98 / $125.53	Professional		$85.36	$112.98	$125.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.85 / $36.86 / $40.95	Professional	26	$27.85	$36.86	$40.95
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.51 / $76.12 / $84.58	Professional	TC	$57.51	$76.12	$84.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.76 / $34.49 / $66.03	Professional		$25.76	$34.49	$66.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.38 / $105.65 / $143.29	Professional		$52.38	$105.65	$143.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.00 / $36.90 / $53.61	Professional	26	$23.00	$36.90	$53.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $67.56 / $88.62	Professional	TC	$25.71	$67.56	$88.62
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $100.73 / $101.74 / $104.80	Professional		$100.73	$101.74	$104.80
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $22.89 / $49.48 / $61.85	Professional	26	$22.89	$49.48	$61.85
United Facility/Professional Professional Modifier Low / Median / High Price $71.65 / $87.40 / $132.97	Professional		$71.65	$87.40	$132.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.63 / $33.67 / $52.93	Professional	26	$26.63	$33.67	$52.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.28 / $53.43 / $84.20	Professional	TC	$42.28	$53.43	$84.20