Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.78 / $71.91 / $267.81	Facility		$40.78	$71.91	$267.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.34 / $10.34 / $13.04	Facility	26	$10.34	$10.34	$13.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.44 / $30.44 / $45.66	Facility	TC	$30.44	$30.44	$45.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.92 / $40.78 / $64.58	Professional		$31.92	$40.78	$64.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $11.28 / $40.82	Professional	26	$8.34	$11.28	$40.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.87 / $29.25 / $51.04	Professional	TC	$22.87	$29.25	$51.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.02 / $35.02 / $35.02	Professional		$35.02	$35.02	$35.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $10.11 / $12.39	Professional	26	$6.74	$10.11	$12.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.52 / $65.05 / $113.06	Facility		$45.52	$65.05	$113.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.95 / $45.42 / $64.54	Professional		$12.95	$45.42	$64.54
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 TC Low / Median / High Price $37.11 / $43.67 / $43.67	Professional	TC	$37.11	$43.67	$43.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.31 / $28.20 / $43.93	Facility		$8.31	$28.20	$43.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.27 / $31.22 / $45.66	Professional		$9.27	$31.22	$45.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.26 / $40.26 / $40.26	Facility		$40.26	$40.26	$40.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.58 / $30.58 / $30.58	Facility	TC	$30.58	$30.58	$30.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.99 / $47.97 / $76.90	Professional		$31.99	$47.97	$76.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $13.45 / $24.90	Professional	26	$7.38	$13.45	$24.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.18 / $31.00 / $58.10	Professional	TC	$21.18	$31.00	$58.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $40.78 / $166.75 / $283.61	Facility		$40.78	$166.75	$283.61
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $9.46 / $10.34 / $10.86	Facility	26	$9.46	$10.34	$10.86
Health Alliance Plan Facility/Professional Facility Modifier TC Low / Median / High Price $20.30 / $45.66 / $211.12	Facility	TC	$20.30	$45.66	$211.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $29.78 / $40.78 / $64.58	Professional		$29.78	$40.78	$64.58
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $10.86 / $31.68	Professional	26	$9.46	$10.86	$31.68
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $20.30 / $29.78 / $50.67	Professional	TC	$20.30	$29.78	$50.67
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 Facility Modifier Low / Median / High Price $77.52 / $177.70 / $299.33	Facility		$77.52	$177.70	$299.33
United Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $38.22 / $56.78	Professional		$32.47	$38.22	$56.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.42 / $12.07 / $19.95	Professional	26	$9.42	$12.07	$19.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.78 / $25.08 / $36.90	Professional	TC	$21.78	$25.08	$36.90