Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.52 / $11.52 / $11.53	Facility	26	$11.52	$11.52	$11.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.76 / $30.46 / $53.65	Professional		$25.76	$30.46	$53.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $9.81 / $19.03	Professional	26	$8.48	$9.81	$19.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.28 / $21.54 / $39.15	Professional	TC	$17.28	$21.54	$39.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.06 / $17.82 / $20.79	Professional	26	$12.06	$17.82	$20.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.94 / $36.24 / $57.37	Professional		$13.94	$36.24	$57.37
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 $36.22 / $36.22 / $36.22	Professional	TC	$36.22	$36.22	$36.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.02 / $26.10 / $40.68	Professional		$10.02	$26.10	$40.68
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 $24.96 / $43.42 / $68.52	Professional		$24.96	$43.42	$68.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $12.01 / $23.87	Professional	26	$7.86	$12.01	$23.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.87 / $29.05 / $56.70	Professional	TC	$15.87	$29.05	$56.70
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.66 / $11.52 / $11.53	Facility	26	$8.66	$11.52	$11.53
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $22.90 / $33.04 / $56.73	Professional		$22.90	$33.04	$56.73
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $10.50 / $17.29	Professional	26	$8.48	$10.50	$17.29
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $14.23 / $21.54 / $40.24	Professional	TC	$14.23	$21.54	$40.24
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 $24.35 / $32.11 / $45.00	Professional		$24.35	$32.11	$45.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.42 / $11.21 / $61.72	Professional	26	$8.42	$11.21	$61.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.15 / $22.37 / $31.03	Professional	TC	$15.15	$22.37	$31.03