Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.28 / $23.28 / $29.34	Facility	26	$23.28	$23.28	$29.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.74 / $68.20 / $204.33	Professional		$55.74	$68.20	$204.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.26 / $23.29 / $79.00	Professional	26	$17.26	$23.29	$79.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.68 / $45.64 / $77.42	Professional	TC	$37.68	$45.64	$77.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.24 / $41.24 / $41.24	Professional		$41.24	$41.24	$41.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $17.03 / $22.99	Professional	26	$13.62	$17.03	$22.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.90 / $70.97 / $93.38	Professional		$25.90	$70.97	$93.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.55 / $27.70 / $27.70	Professional	26	$23.55	$27.70	$27.70
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.19 / $52.19 / $52.19	Professional	TC	$52.19	$52.19	$52.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.71 / $37.60 / $61.30	Professional		$18.71	$37.60	$61.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.10 / $20.10 / $20.10	Facility	26	$20.10	$20.10	$20.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.51 / $75.42 / $156.69	Professional		$51.51	$75.42	$156.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.11 / $24.80 / $51.01	Professional	26	$18.11	$24.80	$51.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.29 / $50.11 / $108.55	Professional	TC	$35.29	$50.11	$108.55
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $18.25 / $23.28 / $24.45	Facility	26	$18.25	$23.28	$24.45
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $52.54 / $64.63 / $195.82	Professional		$52.54	$64.63	$195.82
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $23.28 / $74.86	Professional	26	$17.23	$23.28	$74.86
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.29 / $41.32 / $61.34	Professional	TC	$34.29	$41.32	$61.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $33.64 / $48.31	Professional		$26.80	$33.64	$48.31
United Facility/Professional Professional Modifier Low / Median / High Price $54.50 / $72.63 / $117.94	Professional		$54.50	$72.63	$117.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.37 / $22.84 / $32.70	Professional	26	$18.37	$22.84	$32.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.67 / $43.50 / $90.59	Professional	TC	$35.67	$43.50	$90.59