Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.73 / $11.13 / $33.00	Facility	26	$10.73	$11.13	$33.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $38.49 / $154.78	Professional		$26.80	$38.49	$154.78
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $36.92 / $67.50 / $70.00	Professional	25	$36.92	$67.50	$70.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.57 / $8.88 / $33.13	Professional	26	$7.57	$8.88	$33.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.20 / $28.33 / $35.58	Professional	TC	$19.20	$28.33	$35.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $46.56 / $56.07	Professional		$30.23	$46.56	$56.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.90 / $12.41 / $13.19	Professional	26	$9.90	$12.41	$13.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.60 / $35.60 / $35.60	Professional	TC	$35.60	$35.60	$35.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.90 / $44.88 / $52.80	Professional		$35.90	$44.88	$52.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.22 / $11.53 / $13.56	Professional	26	$9.22	$11.53	$13.56
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.68 / $33.35 / $39.24	Professional	TC	$26.68	$33.35	$39.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.63 / $23.13 / $37.84	Professional		$8.63	$23.13	$37.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.79 / $44.19 / $55.00	Professional		$28.79	$44.19	$55.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $11.13 / $18.27	Professional	26	$7.85	$11.13	$18.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $32.49 / $40.65	Professional	TC	$19.89	$32.49	$40.65
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $36.27 / $60.44 / $64.48	Professional		$36.27	$60.44	$64.48
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $12.91 / $18.98	Professional	26	$11.39	$12.91	$18.98
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $40.94 / $40.94 / $40.94	Professional	TC	$40.94	$40.94	$40.94
United Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $37.89 / $53.11	Professional		$29.46	$37.89	$53.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $9.60 / $15.04	Professional	26	$7.36	$9.60	$15.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $27.43 / $39.36	Professional	TC	$21.10	$27.43	$39.36