Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.81 / $58.37 / $67.23	Facility	26	$52.81	$58.37	$67.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.35 / $138.19 / $239.20	Professional		$92.35	$138.19	$239.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.07 / $54.95 / $90.78	Professional	26	$35.07	$54.95	$90.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.44 / $71.02 / $85.85	Professional	TC	$54.44	$71.02	$85.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $179.22 / $188.79	Professional		$78.00	$179.22	$188.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.09 / $66.06 / $74.39	Professional	26	$37.09	$66.06	$74.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $93.58 / $109.80 / $110.51	Professional	TC	$93.58	$109.80	$110.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.21 / $145.87 / $162.08	Professional		$110.21	$145.87	$162.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.42 / $58.79 / $65.31	Professional	26	$44.42	$58.79	$65.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.80 / $87.08 / $96.76	Professional	TC	$65.80	$87.08	$96.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.60 / $67.09 / $132.88	Professional		$39.60	$67.09	$132.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.72 / $137.50 / $202.88	Professional		$86.72	$137.50	$202.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.29 / $57.56 / $79.29	Professional	26	$33.29	$57.56	$79.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.14 / $85.74 / $123.14	Professional	TC	$53.14	$85.74	$123.14
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $86.41 / $168.39 / $217.11	Professional		$86.41	$168.39	$217.11
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $64.40 / $76.61 / $85.55	Professional	26	$64.40	$76.61	$85.55
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $108.03 / $113.24 / $127.09	Professional	TC	$108.03	$113.24	$127.09
United Facility/Professional Professional Modifier Low / Median / High Price $95.56 / $123.28 / $193.78	Professional		$95.56	$123.28	$193.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.97 / $47.94 / $77.64	Professional	26	$38.97	$47.94	$77.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.57 / $73.88 / $118.46	Professional	TC	$58.57	$73.88	$118.46