Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.72 / $13.49	Facility	26	$10.00	$10.72	$13.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $38.90 / $97.72	Professional		$23.44	$38.90	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.75 / $31.62	Professional	26	$7.08	$11.75	$31.62
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $53.70 / $158.49	Professional	52	$30.20	$53.70	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $25.12 / $53.70	Professional	TC	$15.14	$25.12	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Professional		$67.61	$67.61	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.91 / $11.75	Professional	26	$7.94	$8.91	$11.75
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $4.47 / $5.25 / $9.12	Professional	52	$4.47	$5.25	$9.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $43.65 / $46.77	Professional		$30.20	$43.65	$46.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.45 / $19.50	Professional	26	$14.45	$14.45	$19.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $31.62 / $39.81	Professional	TC	$31.62	$31.62	$39.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $41.69 / $87.10	Professional		$26.30	$41.69	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.88 / $26.30	Professional	26	$7.76	$12.88	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $60.26	Professional	TC	$19.05	$30.20	$60.26
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $13.49 / $26.92	Facility	26	$10.00	$13.49	$26.92
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.02 / $77.62	Professional		$26.92	$38.02	$77.62
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.22 / $25.12	Professional	26	$7.94	$11.22	$25.12
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $32.36 / $158.49	Professional	52	$30.20	$32.36	$158.49
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.30 / $52.48	Professional	TC	$19.05	$26.30	$52.48
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $37.15 / $91.20	Professional		$24.55	$37.15	$91.20
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $11.75 / $24.55	Professional	26	$6.92	$11.75	$24.55
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.70 / $69.18	Professional	TC	$17.38	$25.70	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $37.15 / $54.95	Professional		$29.51	$37.15	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.72 / $16.98	Professional	26	$8.91	$10.72	$16.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.70 / $38.02	Professional	TC	$19.95	$25.70	$38.02