Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.57 / $9.57 / $14.67	Facility	26	$9.57	$9.57	$14.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.45 / $34.38 / $66.84	Professional		$25.45	$34.38	$66.84
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $37.15 / $37.15 / $47.07	Professional	25	$37.15	$37.15	$47.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $8.88 / $23.09	Professional	26	$7.59	$8.88	$23.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.63 / $21.85 / $36.13	Professional	TC	$17.63	$21.85	$36.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.91 / $26.72 / $58.14	Professional		$20.91	$26.72	$58.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.60 / $9.82 / $14.48	Professional	26	$7.60	$9.82	$14.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.95 / $36.10 / $46.95	Professional		$11.95	$36.10	$46.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.86 / $12.78 / $12.78	Professional	26	$10.86	$12.78	$12.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.26 / $30.89 / $30.89	Professional	TC	$26.26	$30.89	$30.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.99 / $23.06 / $34.74	Professional		$8.99	$23.06	$34.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $42.20 / $96.79	Professional		$27.72	$42.20	$96.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.89 / $10.73 / $27.48	Professional	26	$7.89	$10.73	$27.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $30.68 / $69.31	Professional	TC	$19.32	$30.68	$69.31
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.10 / $9.57 / $12.17	Facility	26	$8.10	$9.57	$12.17
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $27.05 / $35.19 / $59.64	Professional		$27.05	$35.19	$59.64
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $37.15 / $37.15 / $37.15	Professional	25	$37.15	$37.15	$37.15
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $9.57 / $18.77	Professional	26	$7.92	$9.57	$18.77
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.36 / $26.22 / $36.33	Professional	TC	$19.36	$26.22	$36.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.09 / $33.09 / $47.38	Professional		$26.09	$33.09	$47.38
United Facility/Professional Professional Modifier Low / Median / High Price $30.68 / $37.89 / $60.61	Professional		$30.68	$37.89	$60.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $9.52 / $14.05	Professional	26	$7.79	$9.52	$14.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.36 / $28.18 / $38.65	Professional	TC	$22.36	$28.18	$38.65