Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.14 / $62.33 / $106.25	Professional		$55.14	$62.33	$106.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.50 / $21.03 / $47.20	Professional	26	$18.50	$21.03	$47.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.65 / $41.30 / $57.68	Professional	TC	$36.65	$41.30	$57.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.01 / $68.01 / $130.29	Professional		$68.01	$68.01	$130.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.56 / $26.15 / $36.29	Professional	26	$22.56	$26.15	$36.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $66.66 / $83.33	Professional		$50.00	$66.66	$83.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.12 / $26.82 / $33.53	Professional	26	$20.12	$26.82	$33.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.88 / $39.84 / $49.80	Professional	TC	$29.88	$39.84	$49.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.98 / $42.77 / $76.15	Facility		$19.98	$42.77	$76.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $39.11 / $59.93	Professional		$19.98	$39.11	$59.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.01 / $60.36 / $100.68	Professional		$33.01	$60.36	$100.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.66 / $27.83 / $44.98	Professional	26	$10.66	$27.83	$44.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $31.17 / $60.82	Professional	TC	$19.80	$31.17	$60.82
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $78.20 / $78.20 / $149.50	Professional		$78.20	$78.20	$149.50
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $25.94 / $25.94 / $41.73	Professional	26	$25.94	$25.94	$41.73
United Facility/Professional Professional Modifier Low / Median / High Price $33.75 / $50.53 / $72.43	Professional		$33.75	$50.53	$72.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.36 / $20.30 / $39.59	Professional	26	$13.36	$20.30	$39.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.39 / $31.89 / $49.01	Professional	TC	$20.39	$31.89	$49.01