Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $30.90 / $46.77	Facility	26	$30.20	$30.90	$46.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $66.07 / $151.36	Professional		$31.62	$66.07	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $34.67 / $91.20	Professional	26	$18.20	$34.67	$91.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.48 / $36.31 / $36.31	Professional	50	$35.48	$36.31	$36.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $26.92 / $51.29	Professional	TC	$8.91	$26.92	$51.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $48.98 / $97.72	Professional		$36.31	$48.98	$97.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.90 / $54.95	Professional	26	$24.55	$30.90	$54.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $23.44 / $47.86	Professional	TC	$14.45	$23.44	$47.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $63.10 / $81.28	Professional		$54.95	$63.10	$81.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $28.84 / $37.15	Professional	26	$25.12	$28.84	$37.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $34.67 / $44.67	Professional	TC	$30.20	$34.67	$44.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $34.67 / $74.13	Professional		$28.18	$34.67	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $97.72	Professional		$33.88	$51.29	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $30.90 / $50.12	Professional	26	$22.39	$30.90	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $18.20 / $52.48	Professional	TC	$10.47	$18.20	$52.48
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $112.20 / $131.83	Professional		$52.48	$112.20	$131.83
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $60.26 / $66.07	Professional	26	$29.51	$60.26	$66.07
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $16.60 / $54.95	Professional	TC	$16.60	$16.60	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $95.50	Professional		$32.36	$54.95	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.30 / $48.98	Professional	26	$19.95	$26.30	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $30.20 / $51.29	Professional	TC	$10.72	$30.20	$51.29