Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.07 / $17.07 / $17.07	Facility	26	$17.07	$17.07	$17.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.20 / $58.64 / $103.77	Professional		$44.20	$58.64	$103.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.98 / $15.46 / $21.87	Professional	26	$12.98	$15.46	$21.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.22 / $41.56 / $69.03	Professional	TC	$31.22	$41.56	$69.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.54 / $52.54 / $52.54	Professional		$52.54	$52.54	$52.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.82 / $10.82 / $11.36	Professional	26	$10.82	$10.82	$11.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.26 / $76.64 / $104.82	Professional		$23.26	$76.64	$104.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.01 / $22.37 / $22.37	Professional	26	$19.01	$22.37	$22.37
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.91 / $63.91 / $63.91	Professional	TC	$63.91	$63.91	$63.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $16.20	Facility	26	$16.20	$16.20	$16.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.62 / $66.53 / $115.53	Professional		$42.62	$66.53	$115.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $17.86 / $34.53	Professional	26	$11.39	$17.86	$34.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.32 / $50.25 / $86.89	Professional	TC	$31.32	$50.25	$86.89
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $11.52 / $11.52 / $17.07	Facility	26	$11.52	$11.52	$17.07
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $58.64 / $100.09	Professional		$42.05	$58.64	$100.09
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.52 / $15.46 / $22.54	Professional	26	$11.52	$15.46	$22.54
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.53 / $41.56 / $64.73	Professional	TC	$30.53	$41.56	$64.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $33.09 / $47.36	Professional		$26.52	$33.09	$47.36
United Facility/Professional Professional Modifier Low / Median / High Price $43.69 / $54.68 / $87.62	Professional		$43.69	$54.68	$87.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.97 / $15.16 / $25.48	Professional	26	$11.97	$15.16	$25.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.82 / $38.97 / $58.46	Professional	TC	$31.82	$38.97	$58.46