Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.38 / $9.38 / $9.38	Facility		$9.38	$9.38	$9.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $12.28 / $12.28 / $12.28	Facility	TC	$12.28	$12.28	$12.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.43 / $18.68 / $33.08	Professional		$15.43	$18.68	$33.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.07 / $15.09 / $39.00	Professional	26	$10.07	$15.09	$39.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.92 / $7.39 / $14.24	Professional	TC	$5.92	$7.39	$14.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.93 / $6.72 / $15.41	Professional	26	$5.93	$6.72	$15.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.45 / $28.86 / $41.01	Professional		$12.45	$28.86	$41.01
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.38 / $14.38 / $19.17	Professional	26	$14.38	$14.38	$19.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.99 / $9.99 / $13.32	Professional	TC	$9.99	$9.99	$13.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.89 / $16.89 / $28.03	Facility		$8.89	$16.89	$28.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $16.51 / $27.47	Professional		$7.41	$16.51	$27.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.44 / $17.80 / $43.07	Professional		$9.44	$17.80	$43.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.48 / $11.44 / $36.40	Professional	26	$5.48	$11.44	$36.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.65 / $4.65 / $11.69	Professional	TC	$3.65	$4.65	$11.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $9.38 / $9.38 / $13.58	Facility		$9.38	$9.38	$13.58
Health Alliance Plan Facility/Professional Facility Modifier TC Low / Median / High Price $9.38 / $9.38 / $13.58	Facility	TC	$9.38	$9.38	$13.58
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $18.67 / $22.05 / $33.08	Professional		$18.67	$22.05	$33.08
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.30 / $15.09 / $39.00	Professional	26	$11.30	$15.09	$39.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $7.13 / $8.73 / $12.80	Professional	TC	$7.13	$8.73	$12.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.33 / $7.67 / $75.00	Professional		$5.33	$7.67	$75.00
United Facility/Professional Professional Modifier Low / Median / High Price $11.60 / $18.34 / $30.81	Professional		$11.60	$18.34	$30.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.60 / $11.78 / $18.19	Professional	26	$7.60	$11.78	$18.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.00 / $6.65 / $11.81	Professional	TC	$4.00	$6.65	$11.81