Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $16.22	Facility	26	$15.14	$15.14	$16.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $47.86 / $147.91	Professional		$21.38	$47.86	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.78 / $44.67	Professional	26	$10.96	$17.78	$44.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $77.62	Professional	TC	$23.99	$37.15	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $32.36 / $45.71	Professional		$27.54	$32.36	$45.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.88 / $21.38	Professional	26	$9.55	$12.88	$21.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $31.62 / $38.02	Professional	TC	$21.38	$31.62	$38.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $63.10 / $67.61	Professional		$43.65	$63.10	$67.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $20.42 / $27.54	Professional	26	$20.42	$20.42	$27.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $46.77 / $46.77	Professional	TC	$39.81	$46.77	$46.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $34.67 / $58.88	Professional		$14.13	$34.67	$58.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $54.95 / $112.20	Professional		$33.11	$54.95	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $17.78 / $37.15	Professional	26	$10.47	$17.78	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $38.90 / $85.11	Professional	TC	$22.91	$38.90	$85.11
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $26.92	Facility	26	$15.14	$15.14	$26.92
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $50.12 / $120.23	Professional		$31.62	$50.12	$120.23
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.22 / $39.81	Professional	26	$10.96	$16.22	$39.81
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.88 / $61.66	Professional	TC	$22.91	$33.88	$61.66
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $39.81 / $91.20	Professional		$29.51	$39.81	$91.20
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.45 / $33.11	Professional	26	$9.12	$14.45	$33.11
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $79.43	Professional	TC	$19.95	$28.84	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $41.69 / $63.10	Professional		$35.48	$41.69	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.13 / $22.39	Professional	26	$12.02	$14.13	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $27.54 / $41.69	Professional	TC	$23.44	$27.54	$41.69