Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.32 / $18.32 / $19.23	Facility	26	$18.32	$18.32	$19.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.64 / $55.49 / $99.61	Professional		$43.64	$55.49	$99.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $18.32 / $39.77	Professional	26	$13.58	$18.32	$39.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.03 / $38.59 / $65.05	Professional	TC	$30.03	$38.59	$65.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.42 / $41.42 / $91.46	Professional		$41.42	$41.42	$91.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.96 / $15.32 / $29.06	Professional	26	$11.96	$15.32	$29.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $64.73 / $90.84	Professional		$22.91	$64.73	$90.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.50 / $24.50 / $24.50	Professional	26	$24.50	$24.50	$24.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.08 / $55.39 / $55.39	Professional	TC	$47.08	$55.39	$55.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.38 / $39.90 / $63.62	Professional		$16.38	$39.90	$63.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $59.51 / $107.15	Professional		$39.47	$59.51	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.62 / $19.11 / $36.96	Professional	26	$11.62	$19.11	$36.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.41 / $39.29 / $77.04	Professional	TC	$26.41	$39.29	$77.04
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.11 / $18.32 / $19.23	Facility	26	$12.11	$18.32	$19.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $38.51 / $56.92 / $89.05	Professional		$38.51	$56.92	$89.05
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.11 / $18.32 / $37.31	Professional	26	$12.11	$18.32	$37.31
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.40 / $38.59 / $62.70	Professional	TC	$26.40	$38.59	$62.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $32.80 / $45.08	Professional		$26.31	$32.80	$45.08
United Facility/Professional Professional Modifier Low / Median / High Price $42.95 / $50.41 / $73.62	Professional		$42.95	$50.41	$73.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.02 / $17.14 / $26.65	Professional	26	$14.02	$17.14	$26.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $32.85 / $49.26	Professional	TC	$28.84	$32.85	$49.26