Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $18.62 / $47.86	Professional		$10.96	$18.62	$47.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $5.37 / $22.91	Professional	26	$3.02	$5.37	$22.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.08 / $12.88 / $25.70	Professional	TC	$7.08	$12.88	$25.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.19 / $4.47 / $5.75	Professional	26	$2.19	$4.47	$5.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $25.12 / $26.92	Professional		$18.62	$25.12	$26.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $6.92 / $9.33	Professional	26	$6.92	$6.92	$9.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $14.79 / $14.79	Professional	TC	$14.79	$14.79	$14.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.07 / $15.14 / $39.81	Facility		$4.07	$15.14	$39.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4.90 / $13.80 / $25.12	Professional		$4.90	$13.80	$25.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $29.51	Facility		$24.55	$24.55	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $20.42 / $63.10	Professional		$7.08	$20.42	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.29 / $5.25 / $16.98	Professional	26	$2.29	$5.25	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $4.68 / $7.76 / $25.70	Professional	TC	$4.68	$7.76	$25.70
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $20.42 / $40.74	Professional		$12.59	$20.42	$40.74
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $3.55 / $5.50 / $15.14	Professional	26	$3.55	$5.50	$15.14
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $8.71 / $14.45 / $30.20	Professional	TC	$8.71	$14.45	$30.20
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $29.51	Facility		$24.55	$24.55	$29.51
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $6.92 / $7.76 / $32.36	Professional		$6.92	$7.76	$32.36
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.86 / $2.29 / $10.96	Professional	26	$1.86	$2.29	$10.96
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.37 / $5.25 / $16.98	Professional	TC	$4.37	$5.25	$16.98
United Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $15.85 / $26.30	Professional		$9.55	$15.85	$26.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.82 / $4.47 / $6.61	Professional	26	$2.82	$4.47	$6.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.76 / $12.02 / $20.89	Professional	TC	$6.76	$12.02	$20.89