Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.56 / $81.08 / $552.49	Professional		$60.56	$81.08	$552.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.37 / $56.62 / $305.23	Professional	26	$31.37	$56.62	$305.23
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.82 / $33.76 / $40.54	Professional	52	$29.82	$33.76	$40.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.87 / $33.09 / $94.71	Professional	TC	$28.87	$33.09	$94.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.98 / $71.17 / $112.15	Professional		$62.98	$71.17	$112.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.33 / $37.65 / $59.93	Professional	26	$33.33	$37.65	$59.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.51 / $33.51 / $33.51	Professional	TC	$33.51	$33.51	$33.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $65.70 / $86.97	Professional		$34.04	$65.70	$86.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.58 / $45.38 / $56.73	Professional	26	$38.58	$45.38	$56.73
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.13 / $31.92 / $39.90	Professional	TC	$27.13	$31.92	$39.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.46 / $38.11 / $78.88	Facility		$29.46	$38.11	$78.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $33.33 / $62.79	Professional		$29.46	$33.33	$62.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.68 / $89.41 / $119.38	Professional		$34.68	$89.41	$119.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.72 / $39.40 / $67.09	Professional	26	$17.72	$39.40	$67.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.67 / $34.10 / $53.41	Professional	TC	$16.67	$34.10	$53.41
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $73.88 / $128.97	Professional		$72.44	$73.88	$128.97
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $43.31 / $44.46 / $68.92	Professional	26	$43.31	$44.46	$68.92
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $38.54 / $38.54 / $38.54	Professional	TC	$38.54	$38.54	$38.54
United Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $67.89 / $136.55	Professional		$38.97	$67.89	$136.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.21 / $35.09 / $57.12	Professional	26	$21.21	$35.09	$57.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.66 / $30.51 / $61.39	Professional	TC	$17.66	$30.51	$61.39