Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $28.84 / $35.48	Facility	26	$28.18	$28.84	$35.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $144.54	Professional		$32.36	$47.86	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.20 / $93.33	Professional	26	$20.89	$30.20	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $19.95 / $72.44	Professional	TC	$10.96	$19.95	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $37.15 / $46.77	Professional		$30.90	$37.15	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.44 / $33.88	Professional	26	$23.44	$23.44	$33.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $120.23 / $128.82	Professional		$45.71	$120.23	$128.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	26	$43.65	$43.65	$43.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $85.11 / $85.11	Professional	TC	$85.11	$85.11	$85.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $34.67 / $87.10	Professional		$19.50	$34.67	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $87.10 / $169.82	Professional		$34.67	$87.10	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.88 / $57.54	Professional	26	$20.89	$33.88	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $47.86 / $112.20	Professional	TC	$14.13	$47.86	$112.20
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $29.51 / $61.66	Facility	26	$28.18	$29.51	$61.66
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $63.10 / $120.23	Professional		$38.90	$63.10	$120.23
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $28.18 / $63.10	Professional	26	$21.38	$28.18	$63.10
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $39.81 / $74.13	Professional	TC	$15.49	$39.81	$74.13
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $83.18 / $154.88	Professional		$36.31	$83.18	$154.88
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $32.36 / $57.54	Professional	26	$20.89	$32.36	$57.54
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $42.66 / $112.20	Professional	TC	$13.80	$42.66	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $79.43 / $104.71	Professional		$45.71	$79.43	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $29.51 / $38.90	Professional	26	$23.44	$29.51	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $50.12 / $69.18	Professional	TC	$21.88	$50.12	$69.18