Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.95 / $43.29 / $49.31	Facility	26	$37.95	$43.29	$49.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.89 / $99.09 / $158.99	Professional		$70.89	$99.09	$158.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.25 / $40.28 / $129.41	Professional	26	$26.25	$40.28	$129.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.35 / $68.70 / $105.25	Professional	TC	$41.35	$68.70	$105.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.33 / $147.94 / $168.10	Professional		$85.33	$147.94	$168.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.23 / $47.75 / $55.48	Professional	26	$22.23	$47.75	$55.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $54.42 / $54.42 / $106.21	Professional	TC	$54.42	$54.42	$106.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.92 / $133.57 / $148.41	Professional		$100.92	$133.57	$148.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.79 / $43.42 / $48.24	Professional	26	$32.79	$43.42	$48.24
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.12 / $90.15 / $100.17	Professional	TC	$68.12	$90.15	$100.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $68.20 / $123.26	Professional		$29.53	$68.20	$123.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.95 / $138.41 / $185.42	Professional		$73.95	$138.41	$185.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.68 / $43.50 / $59.46	Professional	26	$25.68	$43.50	$59.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.49 / $88.85 / $127.48	Professional	TC	$41.49	$88.85	$127.48
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $118.85 / $177.03 / $193.32	Professional		$118.85	$177.03	$193.32
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $37.51 / $56.27 / $71.30	Professional	26	$37.51	$56.27	$71.30
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $58.90 / $62.58 / $122.14	Professional	TC	$58.90	$62.58	$122.14
United Facility/Professional Professional Modifier Low / Median / High Price $94.53 / $115.63 / $178.31	Professional		$94.53	$115.63	$178.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $38.53 / $57.26	Professional	26	$29.23	$38.53	$57.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.39 / $81.78 / $119.04	Professional	TC	$61.39	$81.78	$119.04