Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.12 / $29.12 / $29.13	Facility	26	$29.12	$29.12	$29.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.53 / $51.42 / $77.73	Professional		$47.53	$51.42	$77.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $29.13 / $52.06	Professional	26	$25.82	$29.13	$52.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.22 / $22.73 / $39.24	Professional	TC	$19.22	$22.73	$39.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $64.05 / $64.05	Professional		$64.05	$64.05	$64.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.31 / $41.24 / $41.24	Professional	26	$21.31	$41.24	$41.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $76.73 / $76.73	Professional		$76.73	$76.73	$76.73
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.74 / $43.74 / $43.74	Professional	26	$43.74	$43.74	$43.74
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.00 / $33.00 / $33.00	Professional	TC	$33.00	$33.00	$33.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.02 / $30.51 / $50.58	Professional		$14.02	$30.51	$50.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.14 / $39.28 / $50.31	Professional		$28.14	$39.28	$50.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.04 / $25.29 / $27.89	Professional	26	$16.04	$25.29	$27.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.10 / $13.99 / $22.42	Professional	TC	$12.10	$13.99	$22.42
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $73.66 / $73.66 / $73.66	Professional		$73.66	$73.66	$73.66
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $47.43 / $47.43 / $55.00	Professional	26	$47.43	$47.43	$55.00
United Facility/Professional Professional Modifier Low / Median / High Price $50.74 / $71.04 / $99.72	Professional		$50.74	$71.04	$99.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.62 / $41.24 / $56.64	Professional	26	$27.62	$41.24	$56.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.98 / $30.31 / $43.08	Professional	TC	$21.98	$30.31	$43.08