Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.71 / $54.54 / $58.90	Facility	26	$47.71	$54.54	$58.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.20 / $116.31 / $188.80	Professional		$78.20	$116.31	$188.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.95 / $47.72 / $83.89	Professional	26	$30.95	$47.72	$83.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.97 / $65.19 / $82.85	Professional	TC	$42.97	$65.19	$82.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.16 / $140.19 / $154.84	Professional		$101.16	$140.19	$154.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.63 / $56.31 / $65.43	Professional	26	$26.63	$56.31	$65.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.14 / $84.42 / $91.26	Professional	TC	$77.14	$84.42	$91.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.40 / $123.62 / $137.35	Professional		$93.40	$123.62	$137.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.86 / $51.44 / $57.15	Professional	26	$38.86	$51.44	$57.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.54 / $72.18 / $80.20	Professional	TC	$54.54	$72.18	$80.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.83 / $55.29 / $109.60	Professional		$34.83	$55.29	$109.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.98 / $124.94 / $171.73	Professional		$75.98	$124.94	$171.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.47 / $50.88 / $70.06	Professional	26	$30.47	$50.88	$70.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.06 / $75.70 / $101.67	Professional	TC	$46.06	$75.70	$101.67
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $116.33 / $164.24 / $183.66	Professional		$116.33	$164.24	$183.66
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $46.37 / $64.76 / $69.55	Professional	26	$46.37	$64.76	$69.55
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $88.71 / $93.31 / $104.95	Professional	TC	$88.71	$93.31	$104.95
United Facility/Professional Professional Modifier Low / Median / High Price $87.70 / $107.18 / $164.16	Professional		$87.70	$107.18	$164.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.50 / $43.58 / $70.14	Professional	26	$34.50	$43.58	$70.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.49 / $65.09 / $102.65	Professional	TC	$51.49	$65.09	$102.65