Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.92 / $81.91 / $271.32	Facility		$31.92	$81.91	$271.32
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.93 / $9.93 / $11.15	Facility	26	$9.93	$9.93	$11.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.92 / $23.01 / $245.90	Facility	TC	$21.92	$23.01	$245.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.30 / $31.87 / $72.73	Professional		$24.30	$31.87	$72.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.94 / $29.70	Professional	26	$7.94	$9.94	$29.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.35 / $21.92 / $36.09	Professional	TC	$16.35	$21.92	$36.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.97 / $27.36 / $29.07	Professional		$20.97	$27.36	$29.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $8.94 / $13.09	Professional	26	$6.48	$8.94	$13.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.79 / $46.80 / $81.34	Facility		$33.79	$46.80	$81.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.03 / $41.83 / $51.53	Professional		$23.03	$41.83	$51.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $13.32 / $13.32	Professional	26	$11.32	$13.32	$13.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.71 / $31.42 / $31.42	Professional	TC	$26.71	$31.42	$31.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.98 / $20.32 / $34.34	Facility		$7.98	$20.32	$34.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.90 / $22.66 / $35.53	Professional		$8.90	$22.66	$35.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.32 / $31.32 / $31.32	Facility		$31.32	$31.32	$31.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $22.00 / $22.00 / $22.00	Facility	TC	$22.00	$22.00	$22.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.77 / $33.99 / $65.09	Professional		$23.77	$33.99	$65.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.83 / $10.65 / $20.59	Professional	26	$6.83	$10.65	$20.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $25.46 / $48.84	Professional	TC	$16.30	$25.46	$48.84
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $31.92 / $133.60 / $277.99	Facility		$31.92	$133.60	$277.99
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $7.75 / $9.93 / $11.15	Facility	26	$7.75	$9.93	$11.15
Health Alliance Plan Facility/Professional Facility Modifier TC Low / Median / High Price $21.92 / $30.58 / $235.09	Facility	TC	$21.92	$30.58	$235.09
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $21.99 / $31.87 / $54.64	Professional		$21.99	$31.87	$54.64
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $9.94 / $25.83	Professional	26	$7.75	$9.94	$25.83
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $14.23 / $21.92 / $36.09	Professional	TC	$14.23	$21.92	$36.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $33.09 / $47.38	Professional		$26.31	$33.09	$47.38
United Facility/Professional Professional Modifier Low / Median / High Price $24.54 / $28.87 / $43.83	Professional		$24.54	$28.87	$43.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $9.92 / $14.47	Professional	26	$7.90	$9.92	$14.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.51 / $19.62 / $33.75	Professional	TC	$15.51	$19.62	$33.75