Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $37.15 / $39.81	Facility	26	$27.54	$37.15	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $128.82	Professional		$36.31	$51.29	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.70 / $57.54	Professional	26	$19.05	$25.70	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $21.88 / $34.67	Professional	TC	$15.85	$21.88	$34.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $38.02 / $70.79	Professional		$27.54	$38.02	$70.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $33.11 / $43.65	Professional	26	$18.62	$33.11	$43.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $27.54 / $33.11	Professional	TC	$24.55	$27.54	$33.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $53.70 / $69.18	Professional		$46.77	$53.70	$69.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $30.20 / $38.90	Professional	26	$26.30	$30.20	$38.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $23.44 / $30.20	Professional	TC	$20.42	$23.44	$30.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $25.12 / $52.48	Professional		$18.20	$25.12	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $63.10 / $102.33	Professional		$37.15	$63.10	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $32.36 / $47.86	Professional	26	$20.42	$32.36	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $28.18 / $64.57	Professional	TC	$16.98	$28.18	$64.57
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $72.44 / $85.11	Professional		$43.65	$72.44	$85.11
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $44.67 / $52.48	Professional	26	$22.39	$44.67	$52.48
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $31.62 / $38.02	Professional	TC	$28.84	$31.62	$38.02
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $93.33	Professional		$41.69	$52.48	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $28.18 / $45.71	Professional	26	$22.39	$28.18	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.99 / $46.77	Professional	TC	$18.62	$23.99	$46.77