Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.14 / $31.14 / $39.24	Facility	26	$31.14	$31.14	$39.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.06 / $103.31 / $191.93	Professional		$86.06	$103.31	$191.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.55 / $31.14 / $64.03	Professional	26	$23.55	$31.14	$64.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.40 / $89.04 / $140.53	Professional	TC	$61.40	$89.04	$140.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.33 / $79.23 / $87.81	Professional		$60.33	$79.23	$87.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.77 / $38.36	Professional	26	$19.05	$23.77	$38.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.34 / $134.60 / $191.22	Professional		$38.34	$134.60	$191.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.01 / $41.01 / $41.01	Professional	26	$41.01	$41.01	$41.01
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $129.41 / $129.41 / $129.41	Professional	TC	$129.41	$129.41	$129.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.52 / $93.01 / $129.94	Professional		$27.52	$93.01	$129.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.72 / $29.72 / $29.72	Facility	26	$29.72	$29.72	$29.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.65 / $126.06 / $249.55	Professional		$82.65	$126.06	$249.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.33 / $32.49 / $74.94	Professional	26	$21.33	$32.49	$74.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.10 / $88.80 / $223.32	Professional	TC	$60.10	$88.80	$223.32
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $21.48 / $31.14 / $39.24	Facility	26	$21.48	$31.14	$39.24
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $71.20 / $114.92 / $180.34	Professional		$71.20	$114.92	$180.34
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $21.48 / $28.99 / $53.96	Professional	26	$21.48	$28.99	$53.96
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $49.72 / $86.02 / $132.15	Professional	TC	$49.72	$86.02	$132.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $81.13 / $158.16	Professional		$36.29	$81.13	$158.16
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $115.85 / $150.61	Professional		$91.20	$115.85	$150.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.72 / $31.19 / $42.65	Professional	26	$25.72	$31.19	$42.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.68 / $83.16 / $112.83	Professional	TC	$52.68	$83.16	$112.83