Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.71	Facility	26	$11.16	$11.16	$11.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.33 / $86.79 / $186.55	Professional		$36.33	$86.79	$186.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $11.16 / $42.84	Professional	26	$8.94	$11.16	$42.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.61 / $60.44 / $125.92	Professional	TC	$26.61	$60.44	$125.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.02 / $32.42 / $38.40	Professional		$27.02	$32.42	$38.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.09 / $9.27 / $17.82	Professional	26	$7.09	$9.27	$17.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.94 / $49.29 / $79.33	Professional		$13.94	$49.29	$79.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.67 / $14.91 / $14.91	Professional	26	$12.67	$14.91	$14.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $47.93 / $47.93	Professional	TC	$40.74	$47.93	$47.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.02 / $34.10 / $49.93	Professional		$10.02	$34.10	$49.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.88 / $64.81 / $129.44	Professional		$35.88	$64.81	$129.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $11.82 / $23.13	Professional	26	$7.56	$11.82	$23.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.50 / $50.49 / $113.30	Professional	TC	$28.50	$50.49	$113.30
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.66 / $11.16 / $11.71	Facility	26	$8.66	$11.16	$11.71
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $43.09 / $72.92 / $149.09	Professional		$43.09	$72.92	$149.09
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $11.16 / $27.85	Professional	26	$8.66	$11.16	$27.85
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $31.92 / $49.24 / $95.30	Professional	TC	$31.92	$49.24	$95.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $32.77 / $44.67	Professional		$26.17	$32.77	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $37.78 / $56.02 / $94.89	Professional		$37.78	$56.02	$94.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.88 / $10.37 / $16.78	Professional	26	$7.88	$10.37	$16.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.08 / $38.94 / $83.89	Professional	TC	$27.08	$38.94	$83.89