Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $61.66 / $141.25	Professional		$46.77	$61.66	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.92 / $47.86	Professional	26	$19.05	$26.92	$47.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.88 / $52.48	Professional	TC	$25.70	$33.88	$52.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $74.13 / $93.33	Professional		$53.70	$74.13	$93.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $38.02 / $43.65	Professional	26	$38.02	$38.02	$43.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $33.88 / $33.88	Professional	TC	$33.88	$33.88	$33.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $83.18	Professional		$61.66	$61.66	$83.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $28.18 / $38.02	Professional	26	$28.18	$28.18	$38.02
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $33.88 / $44.67	Professional	TC	$33.88	$33.88	$44.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $33.88 / $58.88	Facility		$25.70	$33.88	$58.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $30.90 / $56.23	Professional		$24.55	$30.90	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $79.43 / $104.71	Professional		$52.48	$79.43	$104.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $32.36 / $51.29	Professional	26	$23.44	$32.36	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $41.69 / $70.79	Professional	TC	$29.51	$41.69	$70.79
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $100.00 / $114.82	Professional		$85.11	$100.00	$114.82
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $43.65 / $50.12	Professional	26	$43.65	$43.65	$50.12
United Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $61.66 / $95.50	Professional		$44.67	$61.66	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.92 / $38.90	Professional	26	$19.05	$26.92	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $34.67 / $53.70	Professional	TC	$25.12	$34.67	$53.70