Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.63 / $17.89 / $26.85	Facility	26	$17.63	$17.89	$26.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.78 / $48.14 / $168.00	Professional		$33.78	$48.14	$168.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $16.95 / $39.10	Professional	26	$10.77	$16.95	$39.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.69 / $25.21 / $33.39	Professional	TC	$20.69	$25.21	$33.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $35.15 / $35.15	Professional		$35.15	$35.15	$35.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $10.83 / $14.86	Professional	26	$10.83	$10.83	$14.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.15 / $54.47 / $60.52	Professional		$41.15	$54.47	$60.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.98 / $23.31	Professional	26	$15.85	$20.98	$23.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.30 / $33.49 / $37.21	Professional	TC	$25.30	$33.49	$37.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.11 / $19.57 / $34.24	Professional		$10.11	$19.57	$34.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.83 / $48.29 / $64.79	Professional		$30.83	$48.29	$64.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.31 / $18.85 / $24.95	Professional	26	$13.31	$18.85	$24.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.79 / $27.34 / $39.84	Professional	TC	$19.79	$27.34	$39.84
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $40.43 / $40.43	Professional		$40.43	$40.43	$40.43
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $17.09 / $17.09 / $17.09	Professional	26	$17.09	$17.09	$17.09
United Facility/Professional Professional Modifier Low / Median / High Price $32.21 / $40.19 / $68.86	Professional		$32.21	$40.19	$68.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $15.88 / $25.10	Professional	26	$13.00	$15.88	$25.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.93 / $26.25 / $42.66	Professional	TC	$18.93	$26.25	$42.66