Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.05 / $4.05 / $5.63	Facility	26	$4.05	$4.05	$5.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.20 / $37.20 / $111.81	Professional		$23.20	$37.20	$111.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.83 / $4.05 / $11.00	Professional	26	$2.83	$4.05	$11.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.01 / $14.94 / $24.59	Professional	52	$10.01	$14.94	$24.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.94 / $25.83 / $44.10	Professional	TC	$18.94	$25.83	$44.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $25.96 / $43.27	Professional		$19.98	$25.96	$43.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.88 / $4.78 / $5.49	Professional	26	$3.88	$4.78	$5.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.19 / $35.19 / $35.19	Professional	TC	$35.19	$35.19	$35.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $34.64 / $34.64	Professional		$26.17	$34.64	$34.64
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.64 / $4.82 / $4.82	Professional	26	$3.64	$4.82	$4.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.53 / $29.82 / $29.82	Professional	TC	$22.53	$29.82	$29.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.02 / $19.23 / $27.59	Professional		$3.02	$19.23	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.97 / $39.75 / $172.70	Professional		$25.97	$39.75	$172.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.40 / $4.90 / $7.00	Professional	26	$3.40	$4.90	$7.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.06 / $33.10 / $134.38	Professional	TC	$21.06	$33.10	$134.38
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $29.85 / $38.33 / $49.76	Professional		$29.85	$38.33	$49.76
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $4.38 / $5.09 / $7.30	Professional	26	$4.38	$5.09	$7.30
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $40.47 / $40.47 / $40.47	Professional	TC	$40.47	$40.47	$40.47
United Facility/Professional Professional Modifier Low / Median / High Price $22.06 / $37.04 / $119.18	Professional		$22.06	$37.04	$119.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.93 / $4.26 / $7.05	Professional	26	$2.93	$4.26	$7.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.71 / $30.26 / $108.12	Professional	TC	$18.71	$30.26	$108.12