Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.90 / $15.90 / $20.03	Facility	26	$15.90	$15.90	$20.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.89 / $34.89 / $64.55	Facility	TC	$34.89	$34.89	$64.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.24 / $50.78 / $79.50	Professional		$40.24	$50.78	$79.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.52 / $15.90 / $43.03	Professional	26	$12.52	$15.90	$43.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.17 / $34.89 / $58.81	Professional	TC	$27.17	$34.89	$58.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $36.86 / $43.37	Professional		$35.22	$36.86	$43.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.30 / $11.18 / $31.59	Professional	26	$10.30	$11.18	$31.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.90 / $55.05 / $90.09	Professional		$23.90	$55.05	$90.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.30 / $21.30 / $21.30	Professional	26	$21.30	$21.30	$21.30
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.55 / $50.06 / $50.06	Professional	TC	$42.55	$50.06	$50.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $15.41	Facility	26	$15.41	$15.41	$15.41
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $35.04	Facility	TC	$35.04	$35.04	$35.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.44 / $60.26 / $95.91	Professional		$39.44	$60.26	$95.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $19.12 / $34.71	Professional	26	$11.42	$19.12	$34.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.50 / $40.47 / $70.22	Professional	TC	$25.50	$40.47	$70.22
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $13.16 / $15.90 / $16.69	Facility	26	$13.16	$15.90	$16.69
Health Alliance Plan Facility/Professional Facility Modifier TC Low / Median / High Price $24.81 / $52.34 / $241.76	Facility	TC	$24.81	$52.34	$241.76
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $50.78 / $81.16	Professional		$37.97	$50.78	$81.16
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.16 / $15.90 / $34.50	Professional	26	$13.16	$15.90	$34.50
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.81 / $34.89 / $58.10	Professional	TC	$24.81	$34.89	$58.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $32.80 / $45.08	Professional		$26.31	$32.80	$45.08
United Facility/Professional Professional Modifier Low / Median / High Price $40.28 / $49.40 / $72.01	Professional		$40.28	$49.40	$72.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.06 / $17.25 / $25.99	Professional	26	$14.06	$17.25	$25.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.08 / $31.64 / $45.34	Professional	TC	$27.08	$31.64	$45.34