Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $251.19	Facility		$35.48	$35.48	$251.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $8.91	Facility	26	$8.91	$8.91	$8.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $35.48 / $93.33	Professional		$20.89	$35.48	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.57 / $6.76 / $21.88	Professional	26	$4.57	$6.76	$21.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.99 / $47.86	Professional	TC	$15.85	$23.99	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $31.62 / $48.98	Professional		$28.18	$31.62	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $4.57 / $10.47	Professional	26	$3.16	$4.57	$10.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $25.12 / $25.12	Professional	TC	$25.12	$25.12	$25.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $28.18 / $37.15	Professional		$25.12	$28.18	$37.15
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $6.92 / $9.12	Professional	26	$6.92	$6.92	$9.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $21.38 / $28.18	Professional	TC	$21.38	$21.38	$28.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $22.91 / $33.11	Facility		$6.31	$22.91	$33.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $19.05 / $28.18	Professional		$6.17	$19.05	$28.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $31.62 / $60.26	Professional		$15.85	$31.62	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $7.08 / $14.13	Professional	26	$3.16	$7.08	$14.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $22.39 / $45.71	Professional	TC	$11.75	$22.39	$45.71
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $36.31 / $57.54	Professional		$32.36	$36.31	$57.54
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.33 / $12.59	Professional	26	$7.76	$9.33	$12.59
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $28.84 / $28.84	Professional	TC	$28.84	$28.84	$28.84
United Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $29.51 / $45.71	Professional		$16.60	$29.51	$45.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.72 / $6.03 / $9.33	Professional	26	$3.72	$6.03	$9.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $22.91 / $37.15	Professional	TC	$12.88	$22.91	$37.15