Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $149.99 / $330.22	Facility		$37.15	$149.99	$330.22
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.19 / $20.82 / $23.01	Facility	26	$18.19	$20.82	$23.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.40 / $37.71 / $48.92	Professional		$26.40	$37.71	$48.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.57 / $18.19 / $37.40	Professional	26	$11.57	$18.19	$37.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $19.52 / $28.80	Professional	TC	$17.89	$19.52	$28.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.12 / $57.12 / $60.09	Professional		$57.12	$57.12	$60.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.39 / $22.07 / $23.66	Professional	26	$15.39	$22.07	$23.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $20.79 / $20.79 / $22.62	Facility		$20.79	$20.79	$22.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.44 / $43.72 / $48.58	Professional		$36.44	$43.72	$48.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $19.61 / $21.79	Professional	26	$16.34	$19.61	$21.79
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.09 / $24.11 / $26.79	Professional	TC	$20.09	$24.11	$26.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.64 / $26.68 / $45.70	Facility		$13.64	$26.68	$45.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.12 / $24.48 / $47.73	Professional		$13.12	$24.48	$47.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.81 / $21.81 / $21.81	Facility		$21.81	$21.81	$21.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.11 / $44.11 / $66.43	Professional		$29.11	$44.11	$66.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.03 / $19.68 / $27.03	Professional	26	$12.03	$19.68	$27.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.69 / $24.20 / $39.10	Professional	TC	$16.69	$24.20	$39.10
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $65.69 / $65.69 / $66.36	Professional		$65.69	$65.69	$66.36
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $21.52 / $24.99 / $27.21	Professional	26	$21.52	$24.99	$27.21
United Facility/Professional Professional Modifier Low / Median / High Price $32.94 / $39.85 / $66.86	Professional		$32.94	$39.85	$66.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.32 / $16.79 / $27.22	Professional	26	$13.32	$16.79	$27.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.69 / $22.53 / $38.97	Professional	TC	$18.69	$22.53	$38.97