Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.17 / $22.17 / $26.14	Facility	26	$22.17	$22.17	$26.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.55 / $78.30 / $104.68	Professional		$50.55	$78.30	$104.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $20.51 / $24.67	Professional	26	$13.58	$20.51	$24.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $56.13 / $80.01	Professional	TC	$36.97	$56.13	$80.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.45 / $99.45 / $115.60	Professional		$99.45	$99.45	$115.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.60 / $28.94 / $33.83	Professional	26	$25.60	$28.94	$33.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $80.47 / $80.47 / $80.47	Professional	TC	$80.47	$80.47	$80.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.78 / $96.33 / $107.03	Professional		$72.78	$96.33	$107.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.22 / $28.08 / $31.20	Professional	26	$21.22	$28.08	$31.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.56 / $68.25 / $75.83	Professional	TC	$51.56	$68.25	$75.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $67.55 / $94.00	Professional		$37.97	$67.55	$94.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $18.45 / $43.00	Professional	26	$11.07	$18.45	$43.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.90 / $49.10 / $112.00	Professional	TC	$26.90	$49.10	$112.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $114.37 / $114.37 / $132.94	Professional		$114.37	$114.37	$132.94
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $29.44 / $33.28 / $37.97	Professional	26	$29.44	$33.28	$37.97
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $92.54 / $92.54 / $92.54	Professional	TC	$92.54	$92.54	$92.54
United Facility/Professional Professional Modifier Low / Median / High Price $66.56 / $119.44 / $181.12	Professional		$66.56	$119.44	$181.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.21 / $22.67 / $37.68	Professional	26	$18.21	$22.67	$37.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.35 / $82.53 / $128.01	Professional	TC	$48.35	$82.53	$128.01