Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.07 / $39.07 / $49.22	Facility	26	$39.07	$39.07	$49.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $50.14 / $170.00	Professional		$28.28	$50.14	$170.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $39.07 / $128.25	Professional	26	$17.17	$39.07	$128.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $95.38 / $95.38 / $95.38	Professional	50	$95.38	$95.38	$95.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $11.47 / $46.89	Professional	TC	$9.18	$11.47	$46.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.17 / $51.17 / $63.12	Professional		$42.17	$51.17	$63.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.32 / $32.58 / $46.38	Professional	26	$24.32	$32.58	$46.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.31 / $99.95 / $221.05	Professional		$47.31	$99.95	$221.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.36 / $52.19 / $52.19	Professional	26	$44.36	$52.19	$52.19
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $205.58 / $205.58 / $205.58	Professional	50	$205.58	$205.58	$205.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.01 / $50.60 / $50.60	Professional	TC	$43.01	$50.60	$50.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $40.56 / $77.06	Professional		$30.40	$40.56	$77.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $37.43 / $37.43	Facility	26	$37.43	$37.43	$37.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.19 / $56.00 / $125.37	Professional		$32.19	$56.00	$125.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.21 / $29.35 / $81.59	Professional	26	$21.21	$29.35	$81.59
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.72 / $70.86 / $84.74	Professional	50	$33.72	$70.86	$84.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.78 / $29.46 / $83.93	Professional	TC	$9.78	$29.46	$83.93
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $19.32 / $39.07 / $41.02	Facility	26	$19.32	$39.07	$41.02
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $28.01 / $51.98 / $133.96	Professional		$28.01	$51.98	$133.96
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.32 / $39.07 / $94.36	Professional	26	$19.32	$39.07	$94.36
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $8.67 / $11.70 / $41.66	Professional	TC	$8.67	$11.70	$41.66
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 $29.38 / $42.22 / $67.68	Professional		$29.38	$42.22	$67.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.98 / $25.38 / $36.46	Professional	26	$20.98	$25.38	$36.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.69 / $12.71 / $36.52	Professional	TC	$9.69	$12.71	$36.52