Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $43.65 / $53.70	Facility	26	$36.31	$43.65	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $323.59	Professional		$85.11	$125.89	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $43.65 / $104.71	Professional	26	$26.92	$43.65	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $81.28 / $141.25	Professional	TC	$54.95	$81.28	$141.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $97.72 / $162.18	Professional		$70.79	$97.72	$162.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.88 / $58.88	Professional	26	$24.55	$33.88	$58.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $77.62 / $120.23	Professional	TC	$26.30	$77.62	$120.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $120.23 / $154.88	Professional		$104.71	$120.23	$154.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $40.74 / $52.48	Professional	26	$35.48	$40.74	$52.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $79.43 / $102.33	Professional	TC	$69.18	$79.43	$102.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $72.44 / $144.54	Professional		$31.62	$72.44	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $141.25 / $199.53	Professional		$89.13	$141.25	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $44.67 / $66.07	Professional	26	$27.54	$44.67	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $89.13 / $134.90	Professional	TC	$58.88	$89.13	$134.90
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $204.17	Professional		$131.83	$186.21	$204.17
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $61.66 / $70.79	Professional	26	$40.74	$61.66	$70.79
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $125.89 / $144.54	Professional	TC	$89.13	$125.89	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $117.49 / $190.55	Professional		$93.33	$117.49	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $38.02 / $63.10	Professional	26	$30.20	$38.02	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $79.43 / $125.89	Professional	TC	$61.66	$79.43	$125.89