Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.82 / $39.95 / $68.28	Facility	26	$35.82	$39.95	$68.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.32 / $103.70 / $129.63	Professional		$45.32	$103.70	$129.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $39.95 / $78.48	Professional	26	$24.78	$39.95	$78.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.19 / $78.92 / $98.28	Professional	TC	$12.19	$78.92	$98.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.09 / $131.91 / $180.88	Professional		$83.09	$131.91	$180.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.47 / $70.63 / $78.87	Professional	26	$39.47	$70.63	$78.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $90.84 / $90.84 / $90.84	Professional	TC	$90.84	$90.84	$90.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.75 / $113.50 / $126.11	Professional		$85.75	$113.50	$126.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.54 / $43.07 / $47.85	Professional	26	$32.54	$43.07	$47.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.22 / $70.43 / $78.26	Professional	TC	$53.22	$70.43	$78.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.41 / $43.87 / $69.13	Professional		$9.41	$43.87	$69.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.19 / $120.30 / $175.56	Professional		$47.19	$120.30	$175.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.34 / $41.47 / $61.11	Professional	26	$30.34	$41.47	$61.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $8.83 / $81.06 / $123.90	Professional	TC	$8.83	$81.06	$123.90
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $95.55 / $95.55 / $169.95	Professional		$95.55	$95.55	$169.95
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $78.06 / $81.22 / $90.70	Professional	26	$78.06	$81.22	$90.70
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $104.47 / $104.47 / $104.47	Professional	TC	$104.47	$104.47	$104.47
United Facility/Professional Professional Modifier Low / Median / High Price $71.14 / $105.21 / $168.76	Professional		$71.14	$105.21	$168.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.93 / $36.65 / $67.04	Professional	26	$28.93	$36.65	$67.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.46 / $56.30 / $120.52	Professional	TC	$21.46	$56.30	$120.52