Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $16.22	Facility	26	$12.88	$12.88	$16.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $53.70 / $117.49	Professional		$33.11	$53.70	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.85 / $38.02	Professional	26	$8.91	$15.85	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.11 / $74.13	Professional	TC	$22.91	$33.11	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.90 / $46.77	Professional		$25.12	$30.90	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $17.78	Professional	26	$7.94	$10.00	$17.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $20.89 / $37.15	Professional	TC	$20.89	$20.89	$37.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $63.10	Professional		$40.74	$58.88	$63.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $16.98 / $22.91	Professional	26	$16.98	$16.98	$22.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $45.71 / $61.66	Professional	TC	$45.71	$45.71	$61.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $33.11 / $54.95	Professional		$11.75	$33.11	$54.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $51.29 / $107.15	Professional		$30.20	$51.29	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.79 / $30.90	Professional	26	$8.71	$14.79	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $38.02 / $83.18	Professional	TC	$22.91	$38.02	$83.18
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $12.88 / $21.88	Facility	26	$12.02	$12.88	$21.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $100.00	Professional		$33.11	$46.77	$100.00
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.80 / $33.88	Professional	26	$9.12	$13.80	$33.88
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $32.36 / $61.66	Professional	TC	$22.91	$32.36	$61.66
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $39.81 / $85.11	Professional		$26.92	$39.81	$85.11
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.75 / $28.18	Professional	26	$7.59	$11.75	$28.18
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $29.51 / $77.62	Professional	TC	$19.95	$29.51	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $39.81 / $60.26	Professional		$33.11	$39.81	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.02 / $18.62	Professional	26	$10.00	$12.02	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $27.54 / $41.69	Professional	TC	$22.91	$27.54	$41.69