Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.83 / $53.86 / $115.84	Facility		$9.83	$53.86	$115.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.09 / $9.09 / $11.45	Facility	26	$9.09	$9.09	$11.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.83 / $13.24 / $27.00	Professional		$10.83	$13.24	$27.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.08 / $17.22	Professional	26	$7.08	$9.08	$17.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.17 / $4.13 / $7.17	Professional	TC	$3.17	$4.13	$7.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6.34 / $8.76 / $15.17	Facility		$6.34	$8.76	$15.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.48 / $15.46 / $21.16	Professional		$5.48	$15.46	$21.16
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.25 / $12.25 / $12.25	Professional	26	$12.25	$12.25	$12.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.61 / $8.61 / $14.56	Facility		$3.61	$8.61	$14.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.60 / $9.22 / $14.18	Professional		$3.60	$9.22	$14.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.68 / $12.68 / $12.68	Facility		$12.68	$12.68	$12.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.76 / $8.76 / $8.76	Facility	26	$8.76	$8.76	$8.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.99 / $15.07 / $32.45	Professional		$9.99	$15.07	$32.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $10.74 / $22.59	Professional	26	$6.50	$10.74	$22.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.00 / $4.88 / $11.69	Professional	TC	$3.00	$4.88	$11.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $9.83 / $34.65 / $84.95	Facility		$9.83	$34.65	$84.95
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $7.61 / $9.09 / $11.45	Facility	26	$7.61	$9.09	$11.45
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $11.26 / $13.24 / $24.05	Professional		$11.26	$13.24	$24.05
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $9.08 / $15.79	Professional	26	$7.61	$9.08	$15.79
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $3.89 / $4.17 / $6.78	Professional	TC	$3.89	$4.17	$6.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.34 / $4.90 / $75.00	Professional		$2.34	$4.90	$75.00
United Facility/Professional Facility Modifier Low / Median / High Price $17.86 / $40.93 / $68.95	Facility		$17.86	$40.93	$68.95
United Facility/Professional Professional Modifier Low / Median / High Price $10.99 / $13.58 / $20.62	Professional		$10.99	$13.58	$20.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $9.66 / $14.40	Professional	26	$7.74	$9.66	$14.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.24 / $4.33 / $7.38	Professional	TC	$3.24	$4.33	$7.38