Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.90 / $44.12 / $50.38	Facility	26	$39.90	$44.12	$50.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.41 / $101.22 / $166.45	Professional		$68.41	$101.22	$166.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.83 / $41.15 / $67.61	Professional	26	$26.83	$41.15	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.58 / $60.06 / $81.81	Professional	TC	$41.58	$60.06	$81.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.84 / $120.79 / $127.07	Professional		$73.84	$120.79	$127.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.09 / $49.16 / $52.76	Professional	26	$23.09	$49.16	$52.76
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.56 / $75.02 / $80.29	Professional	TC	$67.56	$75.02	$80.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.43 / $107.78 / $119.75	Professional		$81.43	$107.78	$119.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.52 / $44.36 / $49.29	Professional	26	$33.52	$44.36	$49.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.91 / $63.41 / $70.45	Professional	TC	$47.91	$63.41	$70.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $49.05 / $97.32	Professional		$30.17	$49.05	$97.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.31 / $115.00 / $150.56	Professional		$67.31	$115.00	$150.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.21 / $44.45 / $60.74	Professional	26	$25.21	$44.45	$60.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.48 / $66.41 / $89.82	Professional	TC	$41.48	$66.41	$89.82
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $123.97 / $138.91 / $146.13	Professional		$123.97	$138.91	$146.13
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $40.04 / $57.24 / $65.19	Professional	26	$40.04	$57.24	$65.19
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $77.69 / $86.27 / $92.33	Professional	TC	$77.69	$86.27	$92.33
United Facility/Professional Professional Modifier Low / Median / High Price $76.98 / $94.37 / $143.90	Professional		$76.98	$94.37	$143.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.63 / $37.75 / $59.34	Professional	26	$29.63	$37.75	$59.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.53 / $59.51 / $90.71	Professional	TC	$45.53	$59.51	$90.71