Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.48 / $17.48 / $22.03	Facility	26	$17.48	$17.48	$22.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.26 / $52.89 / $70.52	Facility	TC	$35.26	$52.89	$70.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.95 / $45.05 / $69.63	Professional		$37.95	$45.05	$69.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.29 / $15.31 / $22.96	Professional	26	$13.29	$15.31	$22.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $28.55 / $46.54	Professional	TC	$23.51	$28.55	$46.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.06 / $36.06 / $36.06	Professional		$36.06	$36.06	$36.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $12.27 / $14.44	Professional	26	$11.32	$12.27	$14.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.91 / $64.81 / $92.11	Professional		$21.91	$64.81	$92.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.43 / $23.43 / $23.43	Professional	26	$23.43	$23.43	$23.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.53 / $49.53 / $49.53	Professional	TC	$49.53	$49.53	$49.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Facility	26	$16.60	$16.60	$16.60
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 $35.36 / $53.04 / $98.22	Professional		$35.36	$53.04	$98.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.94 / $18.91 / $37.60	Professional	26	$11.94	$18.91	$37.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.84 / $33.54 / $65.54	Professional	TC	$23.84	$33.54	$65.54
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.48 / $12.48 / $22.03	Facility	26	$12.48	$12.48	$22.03
Health Alliance Plan Facility/Professional Facility Modifier TC Low / Median / High Price $19.28 / $70.52 / $239.20	Facility	TC	$19.28	$70.52	$239.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $31.76 / $44.34 / $75.37	Professional		$31.76	$44.34	$75.37
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.48 / $15.74 / $23.08	Professional	26	$12.48	$15.74	$23.08
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.28 / $28.35 / $50.83	Professional	TC	$19.28	$28.35	$50.83
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 $38.11 / $45.89 / $65.84	Professional		$38.11	$45.89	$65.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.64 / $17.17 / $26.57	Professional	26	$14.64	$17.17	$26.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.22 / $27.97 / $39.27	Professional	TC	$23.22	$27.97	$39.27