Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.85	Facility	26	$15.14	$15.14	$15.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.88 / $46.77 / $104.71	Facility	TC	$33.88	$46.77	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $154.88	Professional		$32.36	$47.86	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $16.60 / $40.74	Professional	26	$10.72	$16.60	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.20 / $60.26	Professional	TC	$21.38	$30.20	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $35.48 / $38.90	Professional		$31.62	$35.48	$38.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.02 / $22.39	Professional	26	$9.55	$12.02	$22.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $27.54 / $38.90	Professional	TC	$22.39	$27.54	$38.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $63.10 / $67.61	Professional		$44.67	$63.10	$67.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $20.42 / $20.42	Professional	26	$20.42	$20.42	$20.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $47.86 / $47.86	Professional	TC	$47.86	$47.86	$47.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.92 / $32.36 / $46.77	Facility	TC	$6.92	$32.36	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $52.48 / $114.82	Professional		$33.11	$52.48	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $17.78 / $37.15	Professional	26	$10.72	$17.78	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $39.81 / $87.10	Professional	TC	$23.44	$39.81	$87.10
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $31.62	Facility	26	$15.14	$15.14	$31.62
Health Alliance Plan Facility/Professional Facility Modifier TC Low / Median / High Price $33.88 / $51.29 / $104.71	Facility	TC	$33.88	$51.29	$104.71
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $102.33	Professional		$30.90	$46.77	$102.33
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.14 / $34.67	Professional	26	$10.72	$15.14	$34.67
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.90 / $58.88	Professional	TC	$20.42	$30.90	$58.88
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $6.92 / $32.36 / $46.77	Facility	TC	$6.92	$32.36	$46.77
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $41.69 / $91.20	Professional		$31.62	$41.69	$91.20
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.14 / $33.11	Professional	26	$10.23	$15.14	$33.11
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $29.51 / $81.28	Professional	TC	$20.42	$29.51	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $42.66 / $63.10	Professional		$35.48	$42.66	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $15.14 / $22.39	Professional	26	$12.30	$15.14	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $27.54 / $42.66	Professional	TC	$22.91	$27.54	$42.66