Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.51 / $17.51 / $18.39	Facility	26	$17.51	$17.51	$18.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.81 / $75.19 / $128.24	Professional		$56.81	$75.19	$128.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.01 / $17.52 / $27.87	Professional	26	$14.01	$17.52	$27.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.15 / $53.90 / $84.02	Professional	TC	$42.15	$53.90	$84.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.25 / $59.56 / $59.56	Professional		$48.25	$59.56	$59.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.44 / $19.07 / $27.80	Professional	26	$11.44	$19.07	$27.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.91 / $87.05 / $105.37	Professional		$21.91	$87.05	$105.37
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.43 / $23.43 / $23.43	Professional	26	$23.43	$23.43	$23.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.38 / $74.56 / $74.56	Professional	TC	$63.38	$74.56	$74.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.64 / $53.10 / $77.84	Professional		$15.64	$53.10	$77.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.36 / $83.11 / $139.87	Professional		$53.36	$83.11	$139.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.32 / $21.21 / $36.32	Professional	26	$12.32	$21.21	$36.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.95 / $61.10 / $104.37	Professional	TC	$38.95	$61.10	$104.37
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.04 / $17.51 / $18.39	Facility	26	$14.04	$17.51	$18.39
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $53.41 / $70.19 / $111.74	Professional		$53.41	$70.19	$111.74
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.04 / $17.51 / $27.91	Professional	26	$14.04	$17.51	$27.91
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $39.36 / $52.67 / $84.02	Professional	TC	$39.36	$52.67	$84.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $50.77 / $80.02	Professional		$28.58	$50.77	$80.02
United Facility/Professional Professional Modifier Low / Median / High Price $56.27 / $69.62 / $96.97	Professional		$56.27	$69.62	$96.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.75 / $18.53 / $26.48	Professional	26	$14.75	$18.53	$26.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.41 / $49.33 / $78.58	Professional	TC	$41.41	$49.33	$78.58