Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.80 / $27.81 / $35.04	Facility	26	$27.80	$27.81	$35.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.75 / $51.58 / $235.60	Professional		$41.75	$51.58	$235.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $27.81 / $84.46	Professional	26	$21.37	$27.81	$84.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.98 / $23.78 / $38.65	Professional	TC	$18.98	$23.78	$38.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.42 / $40.51 / $77.13	Professional		$36.42	$40.51	$77.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $29.69 / $33.22	Professional	26	$18.30	$29.69	$33.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.62 / $18.35 / $18.35	Professional	TC	$14.62	$18.35	$18.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.33 / $52.29 / $73.11	Professional		$29.33	$52.29	$73.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.28 / $37.28 / $37.28	Professional	26	$37.28	$37.28	$37.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.07 / $28.07 / $33.02	Professional	TC	$28.07	$28.07	$33.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.23 / $28.74 / $52.66	Professional		$20.23	$28.74	$52.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.17 / $63.79 / $123.69	Professional		$38.17	$63.79	$123.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.12 / $29.74 / $67.89	Professional	26	$19.12	$29.74	$67.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $29.47 / $74.26	Professional	TC	$18.32	$29.47	$74.26
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $19.23 / $27.80 / $35.04	Facility	26	$19.23	$27.80	$35.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $51.57 / $111.92	Professional		$34.79	$51.57	$111.92
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $27.80 / $52.15	Professional	26	$19.23	$27.80	$52.15
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $15.56 / $23.78 / $35.67	Professional	TC	$15.56	$23.78	$35.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $46.52 / $80.86	Professional		$28.58	$46.52	$80.86
United Facility/Professional Professional Modifier Low / Median / High Price $44.23 / $54.32 / $83.66	Professional		$44.23	$54.32	$83.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.59 / $26.99 / $37.15	Professional	26	$21.59	$26.99	$37.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.10 / $25.39 / $45.49	Professional	TC	$20.10	$25.39	$45.49