Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $87.10	Facility	26	$72.44	$72.44	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $173.78	Professional		$70.79	$102.33	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $63.10 / $151.36	Professional	26	$44.67	$63.10	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.02 / $70.79	Professional	TC	$20.89	$38.02	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $109.65 / $190.55	Professional		$85.11	$109.65	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $74.13 / $120.23	Professional	26	$48.98	$74.13	$120.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $112.20	Professional		$85.11	$85.11	$112.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $58.88 / $79.43	Professional	26	$58.88	$58.88	$79.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $24.55 / $32.36	Professional	TC	$24.55	$24.55	$32.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $72.44 / $123.03	Professional		$50.12	$72.44	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $186.21	Professional		$81.28	$120.23	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $81.28 / $125.89	Professional	26	$52.48	$81.28	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $69.18	Professional	TC	$25.70	$36.31	$69.18
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $234.42	Professional		$114.82	$169.82	$234.42
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $93.33 / $138.04	Professional	26	$85.11	$93.33	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $93.33 / $144.54	Professional		$77.62	$93.33	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $63.10 / $95.50	Professional	26	$51.29	$63.10	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $32.36 / $53.70	Professional	TC	$24.55	$32.36	$53.70