Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.11 / $13.11 / $13.77	Facility	26	$13.11	$13.11	$13.77
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.96 / $40.54 / $286.37	Facility	TC	$28.96	$40.54	$286.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.19 / $42.09 / $86.70	Professional		$30.19	$42.09	$86.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.31 / $13.12 / $47.50	Professional	26	$10.31	$13.12	$47.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $28.96 / $45.82	Professional	TC	$19.89	$28.96	$45.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $33.54 / $36.00	Professional		$26.17	$33.54	$36.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.90 / $11.86 / $15.71	Professional	26	$8.90	$11.86	$15.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.44 / $52.52 / $69.09	Professional		$16.44	$52.52	$69.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $17.57 / $17.57	Professional	26	$17.57	$17.57	$17.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.31 / $41.54 / $41.54	Professional	TC	$35.31	$41.54	$41.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.82 / $29.93 / $47.09	Professional		$11.82	$29.93	$47.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.24 / $43.90 / $79.33	Professional		$28.24	$43.90	$79.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $13.99 / $27.14	Professional	26	$8.89	$13.99	$27.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.86 / $28.43 / $54.91	Professional	TC	$19.86	$28.43	$54.91
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $9.01 / $13.11 / $13.45	Facility	26	$9.01	$13.11	$13.45
Health Alliance Plan Facility/Professional Facility Modifier TC Low / Median / High Price $28.96 / $43.44 / $241.35	Facility	TC	$28.96	$43.44	$241.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $42.09 / $71.62	Professional		$25.37	$42.09	$71.62
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $13.11 / $32.90	Professional	26	$9.01	$13.11	$32.90
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $16.36 / $28.96 / $44.93	Professional	TC	$16.36	$28.96	$44.93
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 $30.69 / $36.45 / $52.37	Professional		$30.69	$36.45	$52.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.52 / $12.66 / $18.14	Professional	26	$10.52	$12.66	$18.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.71 / $23.31 / $35.77	Professional	TC	$19.71	$23.31	$35.77