Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.39 / $18.39 / $19.32	Facility	26	$18.39	$18.39	$19.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.88 / $70.68 / $114.23	Professional		$37.88	$70.68	$114.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $14.35 / $23.12	Professional	26	$7.33	$14.35	$23.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $52.52 / $91.87	Professional	TC	$24.75	$52.52	$91.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.82 / $12.14 / $15.23	Professional	26	$11.82	$12.14	$15.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.41 / $62.75 / $77.09	Professional		$22.41	$62.75	$77.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.37 / $23.97 / $23.97	Professional	26	$20.37	$23.97	$23.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.81 / $32.22 / $54.51	Professional		$15.81	$32.22	$54.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.97 / $67.09 / $146.56	Professional		$39.97	$67.09	$146.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $14.82 / $36.65	Professional	26	$7.93	$14.82	$36.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.47 / $52.99 / $90.30	Professional	TC	$27.47	$52.99	$90.30
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $6.82 / $18.39 / $19.32	Facility	26	$6.82	$18.39	$19.32
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $52.05 / $104.93	Professional		$46.76	$52.05	$104.93
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $6.82 / $15.23 / $25.89	Professional	26	$6.82	$15.23	$25.89
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $29.80 / $44.67 / $77.70	Professional	TC	$29.80	$44.67	$77.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $32.77 / $44.67	Professional		$26.31	$32.77	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $40.46 / $53.76 / $104.93	Professional		$40.46	$53.76	$104.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $11.86 / $19.05	Professional	26	$7.90	$11.86	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $43.39 / $91.39	Professional	TC	$25.37	$43.39	$91.39