Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.51 / $15.51 / $19.55	Facility	26	$15.51	$15.51	$19.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $51.14 / $80.64	Professional		$34.85	$51.14	$80.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $15.51 / $40.75	Professional	26	$12.59	$15.51	$40.75
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.28 / $25.58 / $25.58	Professional	52	$15.28	$25.58	$25.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $35.63 / $55.94	Professional	TC	$22.26	$35.63	$55.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.99 / $46.99 / $46.99	Professional		$46.99	$46.99	$46.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.10 / $17.63 / $29.26	Professional	26	$11.10	$17.63	$29.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.42 / $53.13 / $77.88	Professional		$19.42	$53.13	$77.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.64 / $20.77 / $20.77	Professional	26	$17.64	$20.77	$20.77
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.91 / $51.66 / $51.66	Professional	TC	$43.91	$51.66	$51.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $37.21 / $57.51	Professional		$13.80	$37.21	$57.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.96 / $14.96 / $14.96	Facility	26	$14.96	$14.96	$14.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.70 / $49.68 / $96.88	Professional		$32.70	$49.68	$96.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.84 / $16.61 / $32.97	Professional	26	$10.84	$16.61	$32.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $33.84 / $68.37	Professional	TC	$20.14	$33.84	$68.37
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.19 / $15.51 / $16.29	Facility	26	$12.19	$15.51	$16.29
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $31.71 / $51.14 / $78.58	Professional		$31.71	$51.14	$78.58
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $15.51 / $36.77	Professional	26	$12.19	$15.51	$36.77
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $19.73 / $25.58 / $54.00	Professional	52	$19.73	$25.58	$54.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.52 / $35.63 / $53.75	Professional	TC	$19.52	$35.63	$53.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $32.77 / $44.67	Professional		$26.31	$32.77	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $34.71 / $42.51 / $57.94	Professional		$34.71	$42.51	$57.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $15.73 / $76.95	Professional	26	$12.19	$15.73	$76.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.80 / $29.14 / $87.90	Professional	TC	$22.80	$29.14	$87.90