Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.74 / $32.74 / $41.25	Facility	26	$32.74	$32.74	$41.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $101.07 / $246.51	Professional		$56.16	$101.07	$246.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.22 / $32.74 / $108.63	Professional	26	$25.22	$32.74	$108.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.76 / $62.60 / $128.65	Professional	TC	$29.76	$62.60	$128.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.40 / $55.64 / $59.31	Professional		$43.40	$55.64	$59.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.28 / $27.32 / $39.14	Professional	26	$20.28	$27.32	$39.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.50 / $32.13 / $32.13	Professional	TC	$29.50	$32.13	$32.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.83 / $82.39 / $104.22	Professional		$40.83	$82.39	$104.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $43.67 / $43.67	Professional	26	$37.11	$43.67	$43.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.27 / $53.26 / $53.26	Professional	TC	$45.27	$53.26	$53.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.38 / $38.42 / $72.33	Professional		$28.38	$38.42	$72.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.56 / $88.40 / $184.30	Professional		$49.56	$88.40	$184.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.06 / $33.54 / $78.72	Professional	26	$22.06	$33.54	$78.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $46.03 / $114.13	Professional	TC	$25.70	$46.03	$114.13
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $22.56 / $32.74 / $34.36	Facility	26	$22.56	$32.74	$34.36
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $66.20 / $88.13 / $159.91	Professional		$66.20	$88.13	$159.91
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.56 / $32.74 / $94.38	Professional	26	$22.56	$32.74	$94.38
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $35.25 / $54.62 / $94.41	Professional	TC	$35.25	$54.62	$94.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.23 / $44.27 / $78.80	Professional		$28.23	$44.27	$78.80
United Facility/Professional Professional Modifier Low / Median / High Price $57.70 / $91.20 / $118.88	Professional		$57.70	$91.20	$118.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.89 / $31.16 / $42.50	Professional	26	$25.89	$31.16	$42.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.80 / $41.70 / $86.52	Professional	TC	$28.80	$41.70	$86.52