Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.84 / $13.61 / $15.81	Facility	26	$12.84	$13.61	$15.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.20 / $70.03 / $138.99	Professional		$34.20	$70.03	$138.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $12.84 / $23.25	Professional	26	$8.52	$12.84	$23.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.44 / $51.90 / $104.41	Professional	TC	$22.44	$51.90	$104.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $57.97 / $59.13	Professional		$28.52	$57.97	$59.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $15.00 / $16.55	Professional	26	$7.02	$15.00	$16.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.87 / $44.87 / $44.87	Professional	TC	$44.87	$44.87	$44.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.18 / $50.53 / $56.14	Professional		$38.18	$50.53	$56.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.14 / $13.42 / $14.91	Professional	26	$10.14	$13.42	$14.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.04 / $37.11 / $41.23	Professional	TC	$28.04	$37.11	$41.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.18 / $29.37 / $44.26	Professional		$9.18	$29.37	$44.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.44 / $68.05 / $156.66	Professional		$39.44	$68.05	$156.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $13.89 / $18.38	Professional	26	$9.00	$13.89	$18.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.68 / $50.55 / $116.78	Professional	TC	$29.68	$50.55	$116.78
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $66.67 / $67.33 / $68.00	Professional		$66.67	$67.33	$68.00
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $12.22 / $17.42 / $19.04	Professional	26	$12.22	$17.42	$19.04
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $51.60 / $51.60 / $51.60	Professional	TC	$51.60	$51.60	$51.60
United Facility/Professional Professional Modifier Low / Median / High Price $36.94 / $65.29 / $122.51	Professional		$36.94	$65.29	$122.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $11.50 / $18.57	Professional	26	$8.61	$11.50	$18.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.47 / $45.02 / $89.12	Professional	TC	$26.47	$45.02	$89.12