Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.31 / $10.31 / $11.15	Facility	26	$10.31	$10.31	$11.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.80 / $28.40 / $54.84	Professional		$22.80	$28.40	$54.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $10.31 / $23.76	Professional	26	$7.95	$10.31	$23.76
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.94 / $52.94 / $52.94	Professional	50	$52.94	$52.94	$52.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.19 / $20.07 / $39.86	Professional	TC	$13.19	$20.07	$39.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.72 / $8.24 / $13.58	Professional	26	$6.72	$8.24	$13.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.95 / $43.03 / $86.05	Professional		$12.95	$43.03	$86.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $13.85 / $13.85	Professional	26	$11.77	$13.85	$13.85
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $65.20 / $76.70 / $76.70	Professional	50	$65.20	$76.70	$76.70
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.83 / $24.50 / $24.50	Professional	TC	$20.83	$24.50	$24.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.25 / $17.67 / $30.10	Professional		$9.25	$17.67	$30.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.96 / $9.96 / $9.96	Facility	26	$9.96	$9.96	$9.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.72 / $33.04 / $62.27	Professional		$21.72	$33.04	$62.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.12 / $10.84 / $21.34	Professional	26	$7.12	$10.84	$21.34
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.04 / $41.47 / $47.09	Professional	50	$30.04	$41.47	$47.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.69 / $23.32 / $45.32	Professional	TC	$14.69	$23.32	$45.32
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.02 / $10.31 / $10.82	Facility	26	$8.02	$10.31	$10.82
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $25.95 / $27.83 / $53.30	Professional		$25.95	$27.83	$53.30
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $10.31 / $22.37	Professional	26	$8.02	$10.31	$22.37
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $52.94 / $52.94 / $52.94	Professional	50	$52.94	$52.94	$52.94
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $16.36 / $18.82 / $32.70	Professional	TC	$16.36	$18.82	$32.70
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 $24.67 / $30.31 / $47.19	Professional		$24.67	$30.31	$47.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $9.38 / $14.55	Professional	26	$7.90	$9.38	$14.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.61 / $20.64 / $31.09	Professional	TC	$16.61	$20.64	$31.09