Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $38.02 / $45.71	Facility	26	$37.15	$38.02	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $53.70 / $144.54	Professional		$39.81	$53.70	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $37.15 / $81.28	Professional	26	$22.91	$37.15	$81.28
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.99 / $44.67 / $95.50	Professional	52	$23.99	$44.67	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $54.95	Professional	TC	$16.98	$25.12	$54.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $75.86	Professional		$33.88	$42.66	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $28.18 / $44.67	Professional	26	$21.38	$28.18	$44.67
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $9.77 / $75.86 / $79.43	Professional	52	$9.77	$75.86	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $29.51 / $34.67	Professional	TC	$17.38	$29.51	$34.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	26	$43.65	$43.65	$43.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $33.11 / $33.11	Professional	TC	$33.11	$33.11	$33.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $37.15 / $77.62	Professional		$21.38	$37.15	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $72.44 / $107.15	Professional		$47.86	$72.44	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $40.74 / $58.88	Professional	26	$27.54	$40.74	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $31.62 / $45.71	Professional	TC	$20.89	$31.62	$45.71
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $87.10 / $89.13	Professional		$58.88	$87.10	$89.13
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $47.86 / $54.95	Professional	26	$23.99	$47.86	$54.95
Qualchoice Facility/Professional Professional Modifier 52 Low / Median / High Price $87.10 / $87.10 / $91.20	Professional	52	$87.10	$87.10	$91.20
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $39.81 / $40.74	Professional	TC	$33.88	$39.81	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $63.10 / $100.00	Professional		$48.98	$63.10	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $34.67 / $56.23	Professional	26	$26.92	$34.67	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $27.54 / $43.65	Professional	TC	$21.88	$27.54	$43.65