Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $15.14 / $18.62	Facility	26	$14.79	$15.14	$18.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $48.98 / $158.49	Professional		$34.67	$48.98	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $18.20 / $50.12	Professional	26	$10.47	$18.20	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.88 / $72.44	Professional	TC	$21.88	$33.88	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $38.90 / $61.66	Professional		$34.67	$38.90	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.88 / $20.42	Professional	26	$9.33	$12.88	$20.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $28.84 / $33.88	Professional	TC	$28.84	$28.84	$33.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $64.57 / $69.18	Professional		$43.65	$64.57	$69.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $19.50	Professional	26	$19.50	$19.50	$19.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $48.98 / $48.98	Professional	TC	$41.69	$48.98	$48.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $36.31 / $53.70	Professional		$12.59	$36.31	$53.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.02 / $14.13 / $20.42	Facility	26	$3.02	$14.13	$20.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $52.48 / $117.49	Professional		$33.11	$52.48	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $17.38 / $35.48	Professional	26	$10.47	$17.38	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $38.90 / $87.10	Professional	TC	$22.91	$38.90	$87.10
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $15.49 / $30.20	Facility	26	$14.13	$15.49	$30.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $114.82	Professional		$32.36	$47.86	$114.82
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.14 / $37.15	Professional	26	$10.23	$15.14	$37.15
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $33.11 / $64.57	Professional	TC	$19.95	$33.11	$64.57
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $3.02 / $14.13 / $20.42	Facility	26	$3.02	$14.13	$20.42
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $40.74 / $93.33	Professional		$30.20	$40.74	$93.33
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.79 / $32.36	Professional	26	$10.00	$14.79	$32.36
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $29.51 / $83.18	Professional	TC	$20.42	$29.51	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $42.66 / $63.10	Professional		$35.48	$42.66	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.45 / $21.88	Professional	26	$12.02	$14.45	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $27.54 / $42.66	Professional	TC	$23.44	$27.54	$42.66