Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.98 / $30.98 / $46.47	Facility	26	$30.98	$30.98	$46.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $65.95 / $149.60	Professional		$28.28	$65.95	$149.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $30.98 / $98.96	Professional	26	$17.17	$30.98	$98.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $26.14 / $38.10	Professional	TC	$9.18	$26.14	$38.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.40 / $97.33 / $101.27	Professional		$52.40	$97.33	$101.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.53 / $38.86 / $60.19	Professional	26	$24.53	$38.86	$60.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.60 / $17.60 / $45.53	Professional	TC	$17.60	$17.60	$45.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.59 / $73.58 / $81.75	Professional		$55.59	$73.58	$81.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.23 / $33.40 / $37.11	Professional	26	$25.23	$33.40	$37.11
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.36 / $40.18 / $44.64	Professional	TC	$30.36	$40.18	$44.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.19 / $38.00 / $73.23	Professional		$28.19	$38.00	$73.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.32 / $52.84 / $96.05	Professional		$35.32	$52.84	$96.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.40 / $32.31 / $47.28	Professional	26	$22.40	$32.31	$47.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.43 / $21.78 / $52.45	Professional	TC	$10.43	$21.78	$52.45
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $52.68 / $111.93 / $116.46	Professional		$52.68	$111.93	$116.46
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $29.50 / $44.69 / $69.22	Professional	26	$29.50	$44.69	$69.22
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $20.23 / $20.23 / $52.36	Professional	TC	$20.23	$20.23	$52.36
United Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $57.68 / $105.52	Professional		$35.40	$57.68	$105.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.72 / $26.20 / $50.68	Professional	26	$20.72	$26.20	$50.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.63 / $31.54 / $52.71	Professional	TC	$10.63	$31.54	$52.71