Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $104.71	Facility	26	$32.36	$32.36	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $123.03 / $263.03	Professional		$87.10	$123.03	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $30.90 / $77.62	Professional	26	$22.39	$30.90	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $85.11 / $128.82	Professional	TC	$60.26	$85.11	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $77.62 / $186.21	Professional		$66.07	$77.62	$186.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.12 / $39.81	Professional	26	$19.05	$25.12	$39.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $81.28 / $81.28	Professional	TC	$81.28	$81.28	$81.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $131.83	Professional		$100.00	$100.00	$131.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $28.18 / $37.15	Professional	26	$28.18	$28.18	$37.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $72.44 / $95.50	Professional	TC	$72.44	$72.44	$95.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $64.57 / $147.91	Professional		$23.99	$64.57	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $144.54 / $190.55	Professional		$95.50	$144.54	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $38.02 / $52.48	Professional	26	$25.70	$38.02	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $102.33 / $147.91	Professional	TC	$70.79	$102.33	$147.91
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $213.80 / $223.87	Professional		$158.49	$213.80	$223.87
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $41.69 / $60.26	Professional	26	$34.67	$41.69	$60.26
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $93.33 / $93.33	Professional	TC	$93.33	$93.33	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $190.55	Professional		$89.13	$120.23	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $32.36 / $51.29	Professional	26	$23.44	$32.36	$51.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $87.10 / $138.04	Professional	TC	$63.10	$87.10	$138.04