Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.93 / $11.93 / $12.53	Facility	26	$11.93	$11.93	$12.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.37 / $39.42 / $61.61	Professional		$31.37	$39.42	$61.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $11.82 / $29.67	Professional	26	$9.52	$11.82	$29.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.80 / $27.48 / $47.78	Professional	TC	$21.80	$27.48	$47.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.90 / $26.71 / $63.36	Professional		$25.90	$26.71	$63.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.42 / $18.98	Professional	26	$7.59	$9.42	$18.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.93 / $47.08 / $64.63	Professional		$17.93	$47.08	$64.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $15.98 / $15.98	Professional	26	$13.58	$15.98	$15.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.50 / $39.40 / $39.40	Professional	TC	$33.50	$39.40	$39.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.74 / $28.41 / $44.08	Professional		$10.74	$28.41	$44.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.56 / $11.56 / $11.56	Facility	26	$11.56	$11.56	$11.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.07 / $42.77 / $74.25	Professional		$29.07	$42.77	$74.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $13.50 / $25.45	Professional	26	$8.11	$13.50	$25.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.85 / $30.34 / $58.10	Professional	TC	$19.85	$30.34	$58.10
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $11.93 / $12.15	Facility	26	$9.61	$11.93	$12.15
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $29.92 / $39.42 / $61.61	Professional		$29.92	$39.42	$61.61
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $11.93 / $25.90	Professional	26	$9.61	$11.93	$25.90
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $20.30 / $27.48 / $46.22	Professional	TC	$20.30	$27.48	$46.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $32.80 / $45.08	Professional		$26.17	$32.80	$45.08
United Facility/Professional Professional Modifier Low / Median / High Price $31.88 / $36.83 / $51.58	Professional		$31.88	$36.83	$51.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $11.99 / $17.97	Professional	26	$9.99	$11.99	$17.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.91 / $24.62 / $35.19	Professional	TC	$20.91	$24.62	$35.19