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 / $11.25	Facility	26	$10.72	$10.72	$11.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.73 / $27.76 / $174.15	Facility	TC	$26.73	$27.76	$174.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $37.40 / $59.54	Professional		$26.78	$37.40	$59.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $10.72 / $24.40	Professional	26	$8.38	$10.72	$24.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $26.03 / $42.04	Professional	TC	$18.32	$26.03	$42.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.25 / $27.60 / $32.47	Professional		$26.25	$27.60	$32.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $8.94 / $12.84	Professional	26	$6.98	$8.94	$12.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.45 / $47.31 / $59.76	Professional		$13.45	$47.31	$59.76
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 $33.04 / $38.88 / $38.88	Professional	TC	$33.04	$38.88	$38.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.63 / $28.02 / $42.29	Professional		$9.63	$28.02	$42.29
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 Facility Modifier TC Low / Median / High Price $27.15 / $27.15 / $27.15	Facility	TC	$27.15	$27.15	$27.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.58 / $36.17 / $71.23	Professional		$24.58	$36.17	$71.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.19 / $11.22 / $22.18	Professional	26	$7.19	$11.22	$22.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.07 / $25.80 / $51.36	Professional	TC	$18.07	$25.80	$51.36
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $7.28 / $10.72 / $11.25	Facility	26	$7.28	$10.72	$11.25
Health Alliance Plan Facility/Professional Facility Modifier TC Low / Median / High Price $26.73 / $40.11 / $188.16	Facility	TC	$26.73	$40.11	$188.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $22.21 / $37.40 / $59.54	Professional		$22.21	$37.40	$59.54
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $10.72 / $23.51	Professional	26	$7.28	$10.72	$23.51
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $14.93 / $26.73 / $42.04	Professional	TC	$14.93	$26.73	$42.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $32.77 / $44.83	Professional		$26.17	$32.77	$44.83
United Facility/Professional Professional Modifier Low / Median / High Price $26.97 / $32.11 / $46.70	Professional		$26.97	$32.11	$46.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $10.36 / $15.61	Professional	26	$8.52	$10.36	$15.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.12 / $21.78 / $31.09	Professional	TC	$18.12	$21.78	$31.09