Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $234.42 / $407.38	Facility		$31.62	$234.42	$407.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $50.12 / $51.29	Facility	26	$40.74	$50.12	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $74.13 / $229.09	Professional		$45.71	$74.13	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $32.36 / $89.13	Professional	26	$25.12	$32.36	$89.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $29.51 / $169.82	Professional	TC	$20.42	$29.51	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $64.57 / $100.00	Professional		$43.65	$64.57	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $32.36 / $53.70	Professional	26	$22.91	$32.36	$53.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.18 / $28.18	Professional	TC	$28.18	$28.18	$28.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $23.99 / $33.11	Facility		$23.99	$23.99	$33.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $64.57 / $83.18	Professional		$56.23	$64.57	$83.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $38.02 / $48.98	Professional	26	$33.11	$38.02	$48.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $26.30 / $33.88	Professional	TC	$22.91	$26.30	$33.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $30.20 / $60.26	Facility		$26.30	$30.20	$60.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $31.62 / $67.61	Professional		$25.70	$31.62	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Facility		$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $100.00 / $223.87	Professional		$51.29	$100.00	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $43.65 / $61.66	Professional	26	$25.70	$43.65	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $41.69 / $190.55	Professional	TC	$22.91	$41.69	$190.55
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $120.23	Professional		$87.10	$104.71	$120.23
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $58.88 / $69.18	Professional	26	$48.98	$58.88	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $87.10 / $208.93	Professional		$52.48	$87.10	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $35.48 / $60.26	Professional	26	$28.84	$35.48	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $36.31 / $158.49	Professional	TC	$22.91	$36.31	$158.49