Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $177.83 / $208.93	Professional		$89.13	$177.83	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $50.12 / $74.13	Professional	26	$33.88	$50.12	$74.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $107.15 / $107.15	Professional	TC	$107.15	$107.15	$107.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $134.90 / $169.82	Professional		$117.49	$134.90	$169.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $52.48 / $67.61	Professional	26	$45.71	$52.48	$67.61
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $81.28 / $104.71	Professional	TC	$70.79	$81.28	$104.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $251.19	Professional		$102.33	$147.91	$251.19
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $239.88	Professional		$204.17	$204.17	$239.88
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $66.07 / $95.50	Professional	26	$63.10	$66.07	$95.50
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	TC	$123.03	$123.03	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $173.78 / $223.87	Professional		$107.15	$173.78	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $45.71 / $83.18	Professional	26	$39.81	$45.71	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $117.49 / $154.88	Professional	TC	$67.61	$117.49	$154.88