Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.41 / $25.73 / $30.87	Facility	26	$23.41	$25.73	$30.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.65 / $103.93 / $164.56	Professional		$81.65	$103.93	$164.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.43 / $23.41 / $50.59	Professional	26	$16.43	$23.41	$50.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.61 / $87.32 / $137.05	Professional	TC	$66.61	$87.32	$137.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $142.06 / $143.49 / $143.49	Professional		$142.06	$143.49	$143.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.42 / $28.48 / $32.76	Professional	26	$19.42	$28.48	$32.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.81 / $120.97 / $134.41	Professional		$100.81	$120.97	$134.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $26.87 / $29.85	Professional	26	$22.39	$26.87	$29.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.42 / $94.10 / $104.56	Professional	TC	$78.42	$94.10	$104.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.44 / $77.33 / $110.95	Professional		$17.44	$77.33	$110.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.52 / $116.82 / $170.92	Professional		$77.52	$116.82	$170.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.42 / $25.51 / $34.36	Professional	26	$17.42	$25.51	$34.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.62 / $89.36 / $134.91	Professional	TC	$59.62	$89.36	$134.91
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $163.37 / $165.01 / $165.01	Professional		$163.37	$165.01	$165.01
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $22.33 / $32.75 / $37.67	Professional	26	$22.33	$32.75	$37.67
United Facility/Professional Professional Modifier Low / Median / High Price $85.46 / $104.69 / $172.76	Professional		$85.46	$104.69	$172.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.22 / $21.04 / $34.61	Professional	26	$17.22	$21.04	$34.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.44 / $88.74 / $137.13	Professional	TC	$68.44	$88.74	$137.13