Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.34 / $10.34 / $10.61	Facility	26	$10.34	$10.34	$10.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.85 / $37.02 / $58.91	Professional		$25.85	$37.02	$58.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $10.25 / $23.85	Professional	26	$7.33	$10.25	$23.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $26.73 / $40.11	Professional	TC	$18.53	$26.73	$40.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.13 / $32.13 / $32.13	Professional		$32.13	$32.13	$32.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.99 / $8.63 / $12.39	Professional	26	$6.99	$8.63	$12.39
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $25.87 / $25.87 / $25.87	Professional	50	$25.87	$25.87	$25.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.60 / $52.73 / $133.12	Professional		$13.60	$52.73	$133.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.85 / $13.85 / $13.85	Professional	26	$13.85	$13.85	$13.85
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $105.46 / $105.46 / $105.46	Professional	50	$105.46	$105.46	$105.46
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.88 / $38.88 / $38.88	Professional	TC	$38.88	$38.88	$38.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.27 / $28.02 / $41.88	Professional		$9.27	$28.02	$41.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.67	Facility	26	$9.67	$9.67	$9.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.87 / $37.21 / $70.52	Professional		$24.87	$37.21	$70.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.27 / $10.60 / $20.94	Professional	26	$6.27	$10.60	$20.94
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.64 / $38.60 / $45.23	Professional	50	$29.64	$38.60	$45.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $27.05 / $51.36	Professional	TC	$17.05	$27.05	$51.36
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $6.55 / $10.34 / $10.61	Facility	26	$6.55	$10.34	$10.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $23.16 / $37.02 / $55.64	Professional		$23.16	$37.02	$55.64
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $10.34 / $16.44	Professional	26	$6.55	$10.34	$16.44
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $16.61 / $26.73 / $40.11	Professional	TC	$16.61	$26.73	$40.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $32.80 / $45.08	Professional		$26.17	$32.80	$45.08
United Facility/Professional Professional Modifier Low / Median / High Price $25.32 / $30.23 / $43.68	Professional		$25.32	$30.23	$43.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.81 / $9.57 / $45.35	Professional	26	$7.81	$9.57	$45.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.42 / $21.60 / $30.51	Professional	TC	$17.42	$21.60	$30.51