Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.10 / $23.10 / $29.98	Facility	26	$23.10	$23.10	$29.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.86 / $64.27 / $195.82	Professional		$48.86	$64.27	$195.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $23.10 / $99.99	Professional	26	$16.32	$23.10	$99.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.83 / $41.17 / $67.88	Professional	TC	$30.83	$41.17	$67.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.30 / $70.30 / $70.30	Professional		$70.30	$70.30	$70.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.73 / $28.60 / $28.60	Professional	26	$23.73	$28.60	$28.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $72.92 / $72.92	Professional		$55.09	$72.92	$72.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.18 / $26.71 / $26.71	Professional	26	$20.18	$26.71	$26.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.90 / $46.21 / $46.21	Professional	TC	$34.90	$46.21	$46.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.21 / $32.00 / $62.17	Professional		$17.21	$32.00	$62.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.60 / $80.42 / $132.47	Professional		$55.60	$80.42	$132.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.52 / $27.88 / $39.93	Professional	26	$19.52	$27.88	$39.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.06 / $52.36 / $84.83	Professional	TC	$35.06	$52.36	$84.83
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $80.84 / $80.84 / $80.84	Professional		$80.84	$80.84	$80.84
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $24.96 / $29.03 / $41.60	Professional	26	$24.96	$29.03	$41.60
United Facility/Professional Professional Modifier Low / Median / High Price $46.33 / $76.45 / $128.34	Professional		$46.33	$76.45	$128.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $24.51 / $37.86	Professional	26	$16.89	$24.51	$37.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.58 / $44.07 / $81.25	Professional	TC	$28.58	$44.07	$81.25