Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.31 / $14.31 / $15.02	Facility	26	$14.31	$14.31	$15.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.92 / $48.09 / $74.89	Professional		$37.92	$48.09	$74.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.75 / $13.65 / $31.05	Professional	26	$9.75	$13.65	$31.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.85 / $33.78 / $58.81	Professional	TC	$26.85	$33.78	$58.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.70 / $33.11 / $34.78	Professional		$29.70	$33.11	$34.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $12.95 / $22.42	Professional	26	$9.27	$12.95	$22.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.92 / $51.77 / $75.30	Professional		$17.92	$51.77	$75.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.90 / $34.53 / $53.48	Professional		$12.90	$34.53	$53.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.86 / $13.86 / $13.86	Facility	26	$13.86	$13.86	$13.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.46 / $48.56 / $90.07	Professional		$34.46	$48.56	$90.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $14.56 / $26.89	Professional	26	$8.94	$14.56	$26.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $36.19 / $71.43	Professional	TC	$24.83	$36.19	$71.43
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $9.34 / $14.31 / $15.02	Facility	26	$9.34	$14.31	$15.02
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $48.09 / $74.89	Professional		$34.95	$48.09	$74.89
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.34 / $14.31 / $26.53	Professional	26	$9.34	$14.31	$26.53
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $25.61 / $33.78 / $56.30	Professional	TC	$25.61	$33.78	$56.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $32.80 / $45.08	Professional		$26.31	$32.80	$45.08
United Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $42.04 / $59.37	Professional		$35.72	$42.04	$59.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.49 / $18.78	Professional	26	$10.00	$12.49	$18.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.44 / $29.49 / $42.22	Professional	TC	$25.44	$29.49	$42.22