Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $14.79 / $18.20	Facility	26	$14.79	$14.79	$18.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $74.13 / $223.87	Professional		$45.71	$74.13	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $20.89 / $53.70	Professional	26	$12.02	$20.89	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $46.77 / $97.72	Professional	TC	$32.36	$46.77	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $42.66 / $70.79	Professional		$35.48	$42.66	$70.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.02 / $23.99	Professional	26	$9.55	$12.02	$23.99
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $44.67 / $56.23	Professional	TC	$29.51	$44.67	$56.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $77.62 / $83.18	Professional		$58.88	$77.62	$83.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $20.42 / $27.54	Professional	26	$20.42	$20.42	$27.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $63.10 / $85.11	Professional	TC	$63.10	$63.10	$85.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $44.67 / $72.44	Professional		$14.13	$44.67	$72.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $69.18 / $141.25	Professional		$42.66	$69.18	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $18.20 / $36.31	Professional	26	$10.96	$18.20	$36.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $52.48 / $112.20	Professional	TC	$30.20	$52.48	$112.20
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $14.79 / $31.62	Facility	26	$14.79	$14.79	$31.62
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $66.07 / $154.88	Professional		$45.71	$66.07	$154.88
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $17.78 / $48.98	Professional	26	$12.02	$17.78	$48.98
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $44.67 / $85.11	Professional	TC	$31.62	$44.67	$85.11
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $54.95 / $112.20	Professional		$38.90	$54.95	$112.20
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.22 / $34.67	Professional	26	$10.00	$16.22	$34.67
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $39.81 / $107.15	Professional	TC	$26.92	$39.81	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $53.70 / $79.43	Professional		$44.67	$53.70	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $15.49 / $23.99	Professional	26	$12.59	$15.49	$23.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $37.15 / $57.54	Professional	TC	$30.90	$37.15	$57.54