Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $12.59 / $15.85	Facility	26	$12.59	$12.59	$15.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $52.48 / $162.18	Professional		$33.11	$52.48	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.14 / $41.69	Professional	26	$8.91	$15.14	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $36.31 / $79.43	Professional	TC	$22.91	$36.31	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $47.86 / $53.70	Professional		$29.51	$47.86	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.23 / $23.44	Professional	26	$9.33	$10.23	$23.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $30.90 / $30.90	Professional	TC	$30.90	$30.90	$30.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $60.26 / $64.57	Professional		$44.67	$60.26	$64.57
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $16.98 / $16.98	Professional	26	$16.98	$16.98	$16.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $40.74 / $47.86	Professional	TC	$40.74	$40.74	$47.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $35.48 / $56.23	Professional		$11.75	$35.48	$56.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $54.95 / $109.65	Professional		$34.67	$54.95	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $15.14 / $30.90	Professional	26	$9.12	$15.14	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $41.69 / $85.11	Professional	TC	$25.70	$41.69	$85.11
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $12.88 / $28.84	Facility	26	$12.02	$12.88	$28.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $51.29 / $107.15	Professional		$35.48	$51.29	$107.15
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.18 / $32.36	Professional	26	$9.77	$13.18	$32.36
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $69.18	Professional	TC	$25.70	$36.31	$69.18
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $100.00	Professional		$32.36	$41.69	$100.00
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.88 / $28.18	Professional	26	$7.59	$12.88	$28.18
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $37.15 / $81.28	Professional	TC	$23.44	$37.15	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $45.71 / $69.18	Professional		$36.31	$45.71	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.30 / $18.62	Professional	26	$10.23	$12.30	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.11 / $50.12	Professional	TC	$25.70	$33.11	$50.12