Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $52.48 / $60.26	Facility	26	$41.69	$52.48	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $104.71 / $213.80	Professional		$69.18	$104.71	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $48.98 / $87.10	Professional	26	$30.20	$48.98	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $52.48 / $97.72	Professional	TC	$36.31	$52.48	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $85.11 / $128.82	Professional		$57.54	$85.11	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.90 / $61.66	Professional	26	$28.18	$38.90	$61.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $79.43 / $81.28	Professional	TC	$33.88	$79.43	$81.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $100.00 / $125.89	Professional		$87.10	$100.00	$125.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $45.71 / $58.88	Professional	26	$39.81	$45.71	$58.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $52.48 / $67.61	Professional	TC	$46.77	$52.48	$67.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $50.12 / $100.00	Professional		$35.48	$50.12	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $117.49 / $162.18	Professional		$70.79	$117.49	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $50.12 / $74.13	Professional	26	$30.90	$50.12	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $64.57 / $91.20	Professional	TC	$39.81	$64.57	$91.20
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $165.96	Professional		$107.15	$131.83	$165.96
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $69.18 / $74.13	Professional	26	$47.86	$69.18	$74.13
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $91.20 / $93.33	Professional	TC	$87.10	$91.20	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $97.72 / $158.49	Professional		$77.62	$97.72	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $42.66 / $70.79	Professional	26	$34.67	$42.66	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $54.95 / $91.20	Professional	TC	$42.66	$54.95	$91.20