Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.08 / $12.09 / $15.23	Facility	26	$12.08	$12.09	$15.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.37 / $58.27 / $146.36	Professional		$26.37	$58.27	$146.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $12.09 / $29.71	Professional	26	$8.83	$12.09	$29.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.54 / $44.33 / $109.79	Professional	TC	$16.54	$44.33	$109.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.92 / $19.92 / $20.11	Professional		$19.92	$19.92	$20.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.26 / $8.91 / $13.37	Professional	26	$7.26	$8.91	$13.37
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $11.27 / $11.27 / $11.27	Professional	TC	$11.27	$11.27	$11.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.51 / $34.86 / $44.09	Professional		$15.51	$34.86	$44.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.67 / $14.91 / $14.91	Professional	26	$12.67	$14.91	$14.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Professional	TC	$26.10	$26.10	$26.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.02 / $18.82 / $32.02	Professional		$10.02	$18.82	$32.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $5.59 / $5.59 / $5.59	Facility	53	$5.59	$5.59	$5.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.83 / $40.88 / $140.12	Professional		$20.83	$40.88	$140.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.34 / $12.28 / $23.13	Professional	26	$7.34	$12.28	$23.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.63 / $25.12 / $143.07	Professional	TC	$12.63	$25.12	$143.07
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $7.87 / $12.08 / $15.23	Facility	26	$7.87	$12.08	$15.23
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $27.92 / $47.00 / $105.14	Professional		$27.92	$47.00	$105.14
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.87 / $12.08 / $18.98	Professional	26	$7.87	$12.08	$18.98
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $17.43 / $30.45 / $70.37	Professional	TC	$17.43	$30.45	$70.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $32.80 / $45.08	Professional		$26.17	$32.80	$45.08
United Facility/Professional Professional Modifier Low / Median / High Price $22.86 / $33.07 / $109.36	Professional		$22.86	$33.07	$109.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $11.12 / $16.23	Professional	26	$9.10	$11.12	$16.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.81 / $19.36 / $93.41	Professional	TC	$12.81	$19.36	$93.41