Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $23.99 / $29.51	Facility	26	$22.91	$23.99	$29.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $67.61 / $218.78	Professional		$51.29	$67.61	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $19.05 / $85.11	Professional	26	$15.85	$19.05	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $44.67 / $60.26	Professional	TC	$36.31	$44.67	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $91.20	Professional		$54.95	$67.61	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $22.39 / $32.36	Professional	26	$15.85	$22.39	$32.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $77.62	Professional		$58.88	$58.88	$77.62
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $25.70	Professional	26	$19.50	$19.50	$25.70
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $39.81 / $52.48	Professional	TC	$39.81	$39.81	$52.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $50.12 / $87.10	Professional		$19.95	$50.12	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $79.43 / $117.49	Professional		$52.48	$79.43	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $25.70 / $37.15	Professional	26	$17.78	$25.70	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $52.48 / $81.28	Professional	TC	$36.31	$52.48	$81.28
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $102.33 / $109.65	Professional		$79.43	$102.33	$109.65
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $29.51 / $37.15	Professional	26	$29.51	$29.51	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $97.72	Professional		$52.48	$64.57	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $20.89 / $33.88	Professional	26	$15.49	$20.89	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $45.71 / $70.79	Professional	TC	$35.48	$45.71	$70.79