Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.34 / $99.40 / $315.02	Facility		$65.34	$99.40	$315.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.39 / $30.20 / $107.10	Facility	26	$26.39	$30.20	$107.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.95 / $218.15 / $390.19	Facility	TC	$38.95	$218.15	$390.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $75.25 / $115.09	Professional		$39.65	$75.25	$115.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.79 / $26.39 / $60.83	Professional	26	$19.79	$26.39	$60.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $234.74 / $234.74 / $281.35	Professional	50	$234.74	$234.74	$281.35
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.40 / $32.67 / $46.61	Professional	52	$14.40	$32.67	$46.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.71 / $38.95 / $74.20	Professional	TC	$13.71	$38.95	$74.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.46 / $43.46 / $43.46	Professional		$43.46	$43.46	$43.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.22 / $110.22 / $110.22	Facility		$110.22	$110.22	$110.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.25 / $69.16 / $76.84	Professional		$52.25	$69.16	$76.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.81 / $31.51 / $35.01	Professional	26	$23.81	$31.51	$35.01
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.44 / $37.65 / $41.83	Professional	TC	$28.44	$37.65	$41.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.48 / $25.53 / $45.95	Facility		$14.48	$25.53	$45.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.47 / $22.95 / $41.91	Professional		$14.47	$22.95	$41.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.39 / $96.39 / $96.39	Facility		$96.39	$96.39	$96.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.04 / $74.08 / $98.48	Professional		$44.04	$74.08	$98.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.27 / $29.08 / $37.64	Professional	26	$21.27	$29.08	$37.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.96 / $44.91 / $65.33	Professional	TC	$18.96	$44.91	$65.33
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $49.98 / $49.98 / $49.98	Professional		$49.98	$49.98	$49.98
United Facility/Professional Professional Modifier Low / Median / High Price $41.16 / $54.56 / $96.43	Professional		$41.16	$54.56	$96.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.67 / $23.94 / $38.61	Professional	26	$18.67	$23.94	$38.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.48 / $31.59 / $60.58	Professional	TC	$20.48	$31.59	$60.58