Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $16.22	Facility	26	$12.88	$12.88	$16.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $46.77 / $141.25	Professional		$31.62	$46.77	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $16.98 / $35.48	Professional	26	$8.51	$16.98	$35.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $31.62 / $77.62	Professional	TC	$21.88	$31.62	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.90 / $45.71	Professional		$30.20	$30.90	$45.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $14.13	Professional	26	$7.94	$10.00	$14.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $63.10	Professional		$42.66	$58.88	$63.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $16.98 / $22.91	Professional	26	$16.98	$16.98	$22.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $45.71 / $61.66	Professional	TC	$45.71	$45.71	$61.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $33.11 / $54.95	Professional		$11.75	$33.11	$54.95
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 $29.51 / $51.29 / $107.15	Professional		$29.51	$51.29	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.80 / $30.90	Professional	26	$8.13	$13.80	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.02 / $83.18	Professional	TC	$21.88	$38.02	$83.18
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $19.95	Facility	26	$12.88	$12.88	$19.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $102.33	Professional		$30.90	$44.67	$102.33
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.88 / $32.36	Professional	26	$8.13	$12.88	$32.36
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $31.62 / $61.66	Professional	TC	$21.88	$31.62	$61.66
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 $26.92 / $38.02 / $85.11	Professional		$26.92	$38.02	$85.11
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.48 / $28.18	Professional	26	$7.59	$11.48	$28.18
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.18 / $77.62	Professional	TC	$19.95	$28.18	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $37.15 / $58.88	Professional		$31.62	$37.15	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.22 / $17.38	Professional	26	$8.91	$11.22	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.92 / $39.81	Professional	TC	$22.39	$26.92	$39.81