Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.39 / $39.47 / $44.58	Facility	26	$36.39	$39.47	$44.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.87 / $70.02 / $145.10	Professional		$47.87	$70.02	$145.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.89 / $34.90 / $68.00	Professional	26	$23.89	$34.90	$68.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.85 / $33.61 / $94.41	Professional	TC	$23.85	$33.61	$94.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.68 / $79.22 / $89.06	Professional		$45.68	$79.22	$89.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $41.92 / $50.46	Professional	26	$20.23	$41.92	$50.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.54 / $44.54 / $49.88	Professional	TC	$44.54	$44.54	$49.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.02 / $75.47 / $83.86	Professional		$57.02	$75.47	$83.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.64 / $39.22 / $43.59	Professional	26	$29.64	$39.22	$43.59
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.38 / $36.24 / $40.27	Professional	TC	$27.38	$36.24	$40.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.87 / $36.10 / $68.98	Professional		$26.87	$36.10	$68.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.43 / $87.88 / $134.51	Professional		$49.43	$87.88	$134.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.23 / $39.31 / $53.51	Professional	26	$23.23	$39.31	$53.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.74 / $43.18 / $91.63	Professional	TC	$24.74	$43.18	$91.63
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $102.42 / $102.42 / $102.42	Professional		$102.42	$102.42	$102.42
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $23.09 / $50.95 / $58.03	Professional	26	$23.09	$50.95	$58.03
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $51.22 / $51.22 / $57.36	Professional	TC	$51.22	$51.22	$57.36
United Facility/Professional Professional Modifier Low / Median / High Price $53.93 / $87.92 / $123.03	Professional		$53.93	$87.92	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.63 / $32.36 / $52.84	Professional	26	$26.63	$32.36	$52.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.29 / $46.38 / $81.63	Professional	TC	$27.29	$46.38	$81.63