Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.52 / $9.52 / $10.01	Facility	26	$9.52	$9.52	$10.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.87 / $37.40 / $91.65	Professional		$25.87	$37.40	$91.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $9.53 / $25.68	Professional	26	$7.03	$9.53	$25.68
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $489.18 / $489.18 / $489.18	Professional	50	$489.18	$489.18	$489.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $27.11 / $52.00	Professional	TC	$18.82	$27.11	$52.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.41 / $31.82 / $31.82	Professional		$19.41	$31.82	$31.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.09 / $9.34 / $15.24	Professional	26	$6.09	$9.34	$15.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.95 / $58.56 / $104.43	Professional		$11.95	$58.56	$104.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.86 / $12.78 / $12.78	Professional	26	$10.86	$12.78	$12.78
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $88.72 / $104.38 / $104.38	Professional	50	$88.72	$104.38	$104.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.50 / $39.40 / $39.40	Professional	TC	$33.50	$39.40	$39.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.52 / $28.34 / $41.38	Professional		$8.52	$28.34	$41.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.11 / $36.76 / $69.70	Professional		$25.11	$36.76	$69.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.30 / $9.93 / $19.75	Professional	26	$6.30	$9.93	$19.75
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.70 / $39.11 / $42.89	Professional	50	$30.70	$39.11	$42.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.53 / $26.85 / $52.08	Professional	TC	$17.53	$26.85	$52.08
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $6.55 / $9.52 / $10.01	Facility	26	$6.55	$9.52	$10.01
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $23.43 / $36.65 / $60.18	Professional		$23.43	$36.65	$60.18
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $9.52 / $20.70	Professional	26	$6.55	$9.52	$20.70
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $489.18 / $489.18 / $489.18	Professional	50	$489.18	$489.18	$489.18
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $16.88 / $27.10 / $45.71	Professional	TC	$16.88	$27.10	$45.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $32.80 / $45.08	Professional		$26.17	$32.80	$45.08
United Facility/Professional Professional Modifier Low / Median / High Price $25.65 / $30.41 / $43.63	Professional		$25.65	$30.41	$43.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.42 / $8.88 / $12.99	Professional	26	$7.42	$8.88	$12.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.84 / $21.82 / $29.91	Professional	TC	$17.84	$21.82	$29.91