Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.74 / $37.74 / $56.61	Facility	26	$37.74	$37.74	$56.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.61 / $66.62 / $134.72	Professional		$47.61	$66.62	$134.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.41 / $36.57 / $65.23	Professional	26	$26.41	$36.57	$65.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.77 / $28.87 / $45.38	Professional	TC	$19.77	$28.87	$45.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $76.17 / $76.17	Professional		$39.36	$76.17	$76.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.22 / $41.24 / $42.06	Professional	26	$26.22	$41.24	$42.06
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $76.17 / $76.17 / $76.17	Professional	52	$76.17	$76.17	$76.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.94 / $34.94 / $34.94	Professional	TC	$34.94	$34.94	$34.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $76.73 / $76.73	Professional		$76.73	$76.73	$76.73
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.74 / $43.74 / $43.74	Professional	26	$43.74	$43.74	$43.74
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.00 / $33.00 / $33.00	Professional	TC	$33.00	$33.00	$33.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.47 / $33.04 / $59.89	Professional		$21.47	$33.04	$59.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.17 / $72.63 / $98.75	Professional		$48.17	$72.63	$98.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.36 / $40.82 / $56.08	Professional	26	$27.36	$40.82	$56.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.02 / $31.59 / $42.66	Professional	TC	$21.02	$31.59	$42.66
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $58.98 / $87.60 / $87.60	Professional		$58.98	$87.60	$87.60
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $47.43 / $47.43 / $48.99	Professional	26	$47.43	$47.43	$48.99
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $40.18 / $40.18 / $40.18	Professional	TC	$40.18	$40.18	$40.18
United Facility/Professional Professional Modifier Low / Median / High Price $50.74 / $71.87 / $99.72	Professional		$50.74	$71.87	$99.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.59 / $41.01 / $56.64	Professional	26	$27.59	$41.01	$56.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.98 / $30.38 / $43.08	Professional	TC	$21.98	$30.38	$43.08