Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $12.02 / $15.14	Facility	26	$12.02	$12.02	$15.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $42.66 / $138.04	Professional		$28.84	$42.66	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.13 / $33.88	Professional	26	$7.94	$14.13	$33.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $27.54 / $63.10	Professional	TC	$19.05	$27.54	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $32.36 / $48.98	Professional		$24.55	$32.36	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.96 / $15.85	Professional	26	$7.76	$10.96	$15.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $28.84 / $28.84	Professional	TC	$28.84	$28.84	$28.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $51.29 / $54.95	Professional		$48.98	$51.29	$54.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $15.85 / $21.38	Professional	26	$15.85	$15.85	$21.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $39.81 / $39.81	Professional	TC	$33.88	$39.81	$39.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $29.51 / $42.66	Professional		$10.23	$29.51	$42.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.45 / $11.48 / $16.22	Facility	26	$2.45	$11.48	$16.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $93.33	Professional		$28.84	$46.77	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $14.13 / $29.51	Professional	26	$8.51	$14.13	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $33.11 / $70.79	Professional	TC	$19.95	$33.11	$70.79
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $12.02 / $28.18	Facility	26	$10.96	$12.02	$28.18
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $40.74 / $87.10	Professional		$30.20	$40.74	$87.10
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.59 / $29.51	Professional	26	$9.12	$12.59	$29.51
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.84 / $51.29	Professional	TC	$20.42	$28.84	$51.29
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $2.45 / $11.48 / $16.22	Facility	26	$2.45	$11.48	$16.22
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $35.48 / $81.28	Professional		$24.55	$35.48	$81.28
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $12.88 / $26.30	Professional	26	$7.24	$12.88	$26.30
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $26.92 / $67.61	Professional	TC	$18.20	$26.92	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $37.15 / $56.23	Professional		$30.90	$37.15	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.02 / $17.78	Professional	26	$10.00	$12.02	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $24.55 / $37.15	Professional	TC	$20.89	$24.55	$37.15