Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.98 / $80.23 / $228.85	Professional		$67.98	$80.23	$228.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $14.62 / $81.59	Professional	26	$10.16	$14.62	$81.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.03 / $65.13 / $81.44	Professional	TC	$58.03	$65.13	$81.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.30 / $78.31 / $104.45	Professional		$69.30	$78.31	$104.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.71 / $12.11 / $19.25	Professional	26	$10.71	$12.11	$19.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $66.20 / $66.20 / $66.20	Professional	TC	$66.20	$66.20	$66.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.80 / $66.63 / $88.18	Professional		$10.80	$66.63	$88.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.24 / $14.40 / $18.00	Professional	26	$12.24	$14.40	$18.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.39 / $63.98 / $79.98	Professional	TC	$54.39	$63.98	$79.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.77 / $62.22 / $88.43	Facility		$10.77	$62.22	$88.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.77 / $45.05 / $68.89	Professional		$10.77	$45.05	$68.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.00 / $69.19 / $115.25	Professional		$27.00	$69.19	$115.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.66 / $12.44 / $20.18	Professional	26	$5.66	$12.44	$20.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.61 / $47.93 / $95.12	Professional	TC	$24.61	$47.93	$95.12
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $81.29 / $90.06 / $120.12	Professional		$81.29	$90.06	$120.12
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $16.13 / $22.14	Professional	26	$13.93	$16.13	$22.14
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $76.13 / $76.13 / $76.13	Professional	TC	$76.13	$76.13	$76.13
United Facility/Professional Professional Modifier Low / Median / High Price $36.06 / $59.00 / $77.23	Professional		$36.06	$59.00	$77.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.68 / $8.77 / $17.11	Professional	26	$6.68	$8.77	$17.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.90 / $38.99 / $64.59	Professional	TC	$28.90	$38.99	$64.59