Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.30 / $11.68 / $32.70	Facility	26	$8.30	$11.68	$32.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.32 / $63.05 / $118.23	Professional		$51.32	$63.05	$118.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $9.36 / $32.85	Professional	26	$7.45	$9.36	$32.85
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.34 / $29.32 / $32.47	Professional	52	$24.34	$29.32	$32.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.84 / $49.82 / $82.01	Professional	TC	$40.84	$49.82	$82.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.95 / $81.86 / $106.59	Professional		$63.95	$81.86	$106.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.78 / $12.53 / $14.29	Professional	26	$10.78	$12.53	$14.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $58.88 / $58.88	Professional	TC	$58.88	$58.88	$58.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.75 / $69.69 / $81.99	Professional		$55.75	$69.69	$81.99
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $12.54 / $14.75	Professional	26	$10.02	$12.54	$14.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.72 / $57.15 / $67.23	Professional	TC	$45.72	$57.15	$67.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.36 / $50.30 / $82.56	Professional		$9.36	$50.30	$82.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.99 / $69.31 / $88.64	Professional		$50.99	$69.31	$88.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $12.02 / $15.29	Professional	26	$8.48	$12.02	$15.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.46 / $56.88 / $73.73	Professional	TC	$42.46	$56.88	$73.73
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $73.54 / $94.14 / $122.58	Professional		$73.54	$94.14	$122.58
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $12.40 / $14.04 / $16.43	Professional	26	$12.40	$14.04	$16.43
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $67.70 / $67.70 / $67.70	Professional	TC	$67.70	$67.70	$67.70
United Facility/Professional Professional Modifier Low / Median / High Price $48.77 / $59.99 / $90.54	Professional		$48.77	$59.99	$90.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $10.27 / $15.95	Professional	26	$7.97	$10.27	$15.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.84 / $51.69 / $80.51	Professional	TC	$39.84	$51.69	$80.51