Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.05 / $52.07 / $60.85	Facility	26	$48.05	$52.07	$60.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.43 / $107.76 / $200.00	Professional		$70.43	$107.76	$200.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.83 / $45.50 / $66.62	Professional	26	$31.83	$45.50	$66.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.50 / $57.21 / $75.77	Professional	TC	$38.50	$57.21	$75.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.09 / $128.94 / $138.54	Professional		$67.09	$128.94	$138.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.40 / $59.96 / $64.26	Professional	26	$33.40	$59.96	$64.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $65.73 / $76.42 / $79.54	Professional	TC	$65.73	$76.42	$79.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.43 / $114.39 / $127.10	Professional		$86.43	$114.39	$127.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.17 / $53.16 / $59.07	Professional	26	$40.17	$53.16	$59.07
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.26 / $61.23 / $68.03	Professional	TC	$46.26	$61.23	$68.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.64 / $48.63 / $97.53	Professional		$35.64	$48.63	$97.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.95 / $117.86 / $158.77	Professional		$70.95	$117.86	$158.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.19 / $52.10 / $71.36	Professional	26	$31.19	$52.10	$71.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.71 / $64.48 / $89.85	Professional	TC	$38.71	$64.48	$89.85
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $77.15 / $148.29 / $165.37	Professional		$77.15	$148.29	$165.37
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $47.62 / $68.95 / $71.44	Professional	26	$47.62	$68.95	$71.44
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $75.59 / $87.88 / $91.47	Professional	TC	$75.59	$87.88	$91.47
United Facility/Professional Professional Modifier Low / Median / High Price $79.58 / $101.17 / $159.16	Professional		$79.58	$101.17	$159.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $45.53 / $70.81	Professional	26	$35.40	$45.53	$70.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.04 / $58.89 / $91.45	Professional	TC	$42.04	$58.89	$91.45