Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.78 / $46.11 / $56.45	Facility	26	$31.78	$46.11	$56.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $113.78 / $128.13	Professional		$72.00	$113.78	$128.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.80 / $38.54 / $56.75	Professional	26	$29.80	$38.54	$56.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $139.38 / $598.00 / $1,196.00	Professional	50	$139.38	$598.00	$1,196.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.64 / $77.84 / $82.53	Professional	TC	$47.64	$77.84	$82.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.25 / $153.55 / $172.73	Professional		$76.25	$153.55	$172.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.64 / $57.73 / $95.86	Professional	26	$25.64	$57.73	$95.86
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $228.04 / $230.33 / $259.08	Professional	50	$228.04	$230.33	$259.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.02 / $136.35 / $151.50	Professional		$103.02	$136.35	$151.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.54 / $49.69 / $55.21	Professional	26	$37.54	$49.69	$55.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.48 / $86.66 / $96.29	Professional	TC	$65.48	$86.66	$96.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.02 / $66.11 / $126.58	Professional		$34.02	$66.11	$126.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.42 / $136.84 / $190.49	Professional		$84.42	$136.84	$190.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.50 / $49.80 / $68.08	Professional	26	$29.50	$49.80	$68.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.08 / $86.96 / $122.41	Professional	TC	$54.08	$86.96	$122.41
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $149.50 / $176.58 / $198.64	Professional		$149.50	$176.58	$198.64
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $29.26 / $66.39 / $110.24	Professional	26	$29.26	$66.39	$110.24
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $262.25 / $262.25 / $297.95	Professional	50	$262.25	$262.25	$297.95
United Facility/Professional Professional Modifier Low / Median / High Price $96.85 / $121.61 / $182.69	Professional		$96.85	$121.61	$182.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.45 / $42.53 / $67.20	Professional	26	$33.45	$42.53	$67.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.05 / $76.88 / $116.65	Professional	TC	$61.05	$76.88	$116.65