Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.75 / $12.75 / $13.38	Facility	26	$12.75	$12.75	$13.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $44.67 / $71.70	Professional		$34.17	$44.67	$71.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $12.75 / $31.13	Professional	26	$9.41	$12.75	$31.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $31.93 / $53.79	Professional	TC	$24.75	$31.93	$53.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.33 / $31.00 / $38.26	Professional		$29.33	$31.00	$38.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $10.18 / $15.27	Professional	26	$8.27	$10.18	$15.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.93 / $55.82 / $70.51	Professional		$15.93	$55.82	$70.51
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.48 / $17.04 / $17.04	Professional	26	$14.48	$17.04	$17.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.93 / $45.80 / $45.80	Professional	TC	$38.93	$45.80	$45.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $32.99 / $50.04	Professional		$11.48	$32.99	$50.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.58 / $46.37 / $84.28	Professional		$30.58	$46.37	$84.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.05 / $13.29 / $27.14	Professional	26	$8.05	$13.29	$27.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.57 / $34.81 / $61.13	Professional	TC	$21.57	$34.81	$61.13
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.41 / $12.75 / $13.38	Facility	26	$8.41	$12.75	$13.38
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $30.04 / $44.67 / $70.16	Professional		$30.04	$44.67	$70.16
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $12.75 / $27.66	Professional	26	$8.41	$12.75	$27.66
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $31.92 / $53.14	Professional	TC	$21.64	$31.92	$53.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $33.09 / $47.38	Professional		$26.31	$33.09	$47.38
United Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $39.72 / $54.47	Professional		$34.79	$39.72	$54.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $12.49 / $38.82	Professional	26	$10.11	$12.49	$38.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.45 / $27.68 / $40.68	Professional	TC	$24.45	$27.68	$40.68