Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.11 / $15.11 / $15.12	Facility	26	$15.11	$15.11	$15.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.78 / $33.78 / $229.23	Facility	TC	$33.78	$33.78	$229.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $42.13 / $75.87	Professional		$35.22	$42.13	$75.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $13.93 / $31.80	Professional	26	$11.48	$13.93	$31.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $28.95 / $51.90	Professional	TC	$23.17	$28.95	$51.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.45 / $41.45 / $41.56	Professional		$41.45	$41.45	$41.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $12.68 / $18.09	Professional	26	$9.80	$12.68	$18.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.92 / $60.55 / $76.48	Professional		$18.92	$60.55	$76.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $20.23 / $20.23	Professional	26	$20.23	$20.23	$20.23
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.93 / $47.93 / $47.93	Professional	TC	$47.93	$47.93	$47.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $33.92 / $33.92 / $33.92	Facility	TC	$33.92	$33.92	$33.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $49.79 / $91.61	Professional		$33.04	$49.79	$91.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.26 / $16.32 / $31.26	Professional	26	$10.26	$16.32	$31.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.42 / $33.10 / $63.41	Professional	TC	$23.42	$33.10	$63.41
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $15.11 / $15.39	Facility	26	$10.80	$15.11	$15.39
Health Alliance Plan Facility/Professional Facility Modifier TC Low / Median / High Price $33.78 / $50.67 / $231.52	Facility	TC	$33.78	$50.67	$231.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $29.81 / $44.21 / $75.87	Professional		$29.81	$44.21	$75.87
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $14.20 / $24.12	Professional	26	$10.80	$14.20	$24.12
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.02 / $31.64 / $51.68	Professional	TC	$19.02	$31.64	$51.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $32.77 / $44.83	Professional		$26.31	$32.77	$44.83
United Facility/Professional Professional Modifier Low / Median / High Price $35.84 / $42.48 / $61.33	Professional		$35.84	$42.48	$61.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.38 / $15.18 / $21.45	Professional	26	$12.38	$15.18	$21.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $27.08 / $38.72	Professional	TC	$22.91	$27.08	$38.72