Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $147.91 / $363.08	Facility		$37.15	$147.91	$363.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $20.89 / $22.91	Facility	26	$18.20	$20.89	$22.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $37.15 / $72.44	Professional		$25.70	$37.15	$72.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.79 / $39.81	Professional	26	$10.00	$14.79	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $21.88 / $37.15	Professional	TC	$16.98	$21.88	$37.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $28.84 / $58.88	Professional		$26.92	$28.84	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.45 / $23.99	Professional	26	$10.23	$14.45	$23.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $20.89 / $28.18	Facility		$20.89	$20.89	$28.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.02 / $48.98	Professional		$33.11	$38.02	$48.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $16.98 / $21.88	Professional	26	$14.79	$16.98	$21.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $20.89 / $26.92	Professional	TC	$18.20	$20.89	$26.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $22.91 / $38.90	Facility		$13.49	$22.91	$38.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $25.12 / $50.12	Professional		$13.18	$25.12	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Facility		$21.88	$21.88	$21.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $42.66 / $67.61	Professional		$28.84	$42.66	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $19.05 / $28.18	Professional	26	$11.75	$19.05	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.99 / $40.74	Professional	TC	$15.85	$23.99	$40.74
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $67.61 / $70.79	Professional		$66.07	$67.61	$70.79
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $25.70 / $29.51	Professional	26	$21.38	$25.70	$29.51
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.02 / $63.10	Professional		$30.90	$38.02	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.22 / $26.92	Professional	26	$12.88	$16.22	$26.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.39 / $36.31	Professional	TC	$16.98	$22.39	$36.31