Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $15.49 / $16.26	Facility	26	$15.49	$15.49	$16.26
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.67 / $32.67 / $49.01	Facility	TC	$32.67	$32.67	$49.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $42.06 / $70.51	Professional		$35.39	$42.06	$70.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.56 / $13.57 / $20.35	Professional	26	$11.56	$13.57	$20.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $28.00 / $49.01	Professional	TC	$22.85	$28.00	$49.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.85 / $10.03 / $12.25	Professional	26	$9.85	$10.03	$12.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.42 / $59.61 / $75.30	Professional		$19.42	$59.61	$75.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.64 / $20.77 / $20.77	Professional	26	$17.64	$20.77	$20.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.65 / $49.40 / $90.19	Professional		$32.65	$49.40	$90.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.40 / $16.64 / $32.00	Professional	26	$10.40	$16.64	$32.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.65 / $32.64 / $61.29	Professional	TC	$22.65	$32.64	$61.29
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.87 / $15.49 / $16.26	Facility	26	$10.87	$15.49	$16.26
Health Alliance Plan Facility/Professional Facility Modifier TC Low / Median / High Price $18.75 / $49.01 / $223.84	Facility	TC	$18.75	$49.01	$223.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $29.63 / $42.40 / $69.37	Professional		$29.63	$42.40	$69.37
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.87 / $14.49 / $21.79	Professional	26	$10.87	$14.49	$21.79
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.75 / $28.23 / $48.86	Professional	TC	$18.75	$28.23	$48.86
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 $35.57 / $41.23 / $61.28	Professional		$35.57	$41.23	$61.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.69 / $15.58 / $75.40	Professional	26	$12.69	$15.58	$75.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.58 / $27.19 / $38.15	Professional	TC	$22.58	$27.19	$38.15