Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $10.72 / $13.50	Facility	26	$10.72	$10.72	$13.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.00 / $34.52 / $52.53	Professional		$27.00	$34.52	$52.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $10.72 / $15.18	Professional	26	$8.38	$10.72	$15.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.61 / $16.32 / $17.26	Professional	52	$9.61	$16.32	$17.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.34 / $25.05 / $41.07	Professional	TC	$17.34	$25.05	$41.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.07 / $24.07 / $53.02	Professional		$24.07	$24.07	$53.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $7.60 / $12.08	Professional	26	$6.98	$7.60	$12.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.19 / $27.19 / $27.19	Professional	TC	$27.19	$27.19	$27.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.45 / $33.24 / $52.00	Professional		$13.45	$33.24	$52.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.22 / $14.38 / $14.38	Professional	26	$12.22	$14.38	$14.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.17 / $31.96 / $31.96	Professional	TC	$27.17	$31.96	$31.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.34 / $40.92 / $76.09	Professional		$26.34	$40.92	$76.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $12.28 / $22.18	Professional	26	$7.37	$12.28	$22.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.18 / $30.33 / $56.70	Professional	TC	$19.18	$30.33	$56.70
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $9.34 / $10.72 / $12.99	Facility	26	$9.34	$10.72	$12.99
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $31.41 / $34.27 / $53.73	Professional		$31.41	$34.27	$53.73
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.34 / $10.72 / $19.70	Professional	26	$9.34	$10.72	$19.70
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $12.45 / $16.32 / $37.08	Professional	52	$12.45	$16.32	$37.08
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $24.06 / $38.85	Professional	TC	$21.32	$24.06	$38.85
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 $30.17 / $38.43 / $55.51	Professional		$30.17	$38.43	$55.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.25 / $11.40 / $32.84	Professional	26	$9.25	$11.40	$32.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.85 / $25.77 / $38.18	Professional	TC	$19.85	$25.77	$38.18