Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.15 / $48.15 / $72.23	Facility	26	$48.15	$48.15	$72.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.50 / $70.61 / $112.98	Professional		$59.50	$70.61	$112.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.98 / $42.58 / $56.83	Professional	26	$30.98	$42.58	$56.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.05 / $23.58 / $43.57	Professional	TC	$21.05	$23.58	$43.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $90.71 / $114.81	Professional		$75.31	$90.71	$114.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.97 / $50.96 / $59.93	Professional	26	$44.97	$50.96	$59.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.04 / $85.05 / $90.05	Professional		$68.04	$85.05	$90.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.06 / $52.58 / $55.67	Professional	26	$42.06	$52.58	$55.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.98 / $32.47 / $34.38	Professional	TC	$25.98	$32.47	$34.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.52 / $47.55 / $91.92	Professional		$40.52	$47.55	$91.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.30 / $90.35 / $132.97	Professional		$63.30	$90.35	$132.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.64 / $56.10 / $72.33	Professional	26	$34.64	$56.10	$72.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.28 / $31.94 / $58.36	Professional	TC	$26.28	$31.94	$58.36
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $86.62 / $105.10 / $175.16	Professional		$86.62	$105.10	$175.16
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $38.28 / $57.21 / $68.92	Professional	26	$38.28	$57.21	$68.92
United Facility/Professional Professional Modifier Low / Median / High Price $59.72 / $75.45 / $112.09	Professional		$59.72	$75.45	$112.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.75 / $46.33 / $68.91	Professional	26	$33.75	$46.33	$68.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.57 / $30.20 / $56.24	Professional	TC	$20.57	$30.20	$56.24