Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.29 / $34.86 / $41.03	Facility	26	$28.29	$34.86	$41.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.06 / $104.43 / $128.87	Professional		$74.06	$104.43	$128.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $28.36 / $47.16	Professional	26	$22.71	$28.36	$47.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.36 / $77.14 / $94.98	Professional	TC	$55.36	$77.14	$94.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.25 / $84.25 / $84.25	Professional		$84.25	$84.25	$84.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.86 / $40.79 / $42.44	Professional	26	$18.86	$40.79	$42.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.22 / $143.22 / $159.13	Professional		$108.22	$143.22	$159.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.17 / $37.29 / $41.43	Professional	26	$28.17	$37.29	$41.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.04 / $105.94 / $117.71	Professional	TC	$80.04	$105.94	$117.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.23 / $79.29 / $131.13	Professional		$25.23	$79.29	$131.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.70 / $122.80 / $194.58	Professional		$83.70	$122.80	$194.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.07 / $37.42 / $50.83	Professional	26	$22.07	$37.42	$50.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.27 / $85.14 / $144.13	Professional	TC	$58.27	$85.14	$144.13
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $33.29 / $46.91 / $48.81	Professional	26	$33.29	$46.91	$48.81
United Facility/Professional Professional Modifier Low / Median / High Price $96.73 / $120.01 / $185.97	Professional		$96.73	$120.01	$185.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.34 / $31.93 / $50.19	Professional	26	$25.34	$31.93	$50.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.67 / $90.25 / $139.58	Professional	TC	$71.67	$90.25	$139.58