Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.56 / $11.98 / $15.09	Facility	26	$9.56	$11.98	$15.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.21 / $57.45 / $107.25	Professional		$36.21	$57.45	$107.25
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $90.40 / $90.40 / $90.40	Professional	25	$90.40	$90.40	$90.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.68 / $13.03 / $35.01	Professional	26	$9.68	$13.03	$35.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.42 / $35.14 / $58.84	Professional	TC	$26.42	$35.14	$58.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.89 / $35.28 / $63.89	Professional		$29.89	$35.28	$63.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $11.47 / $18.07	Professional	26	$8.52	$11.47	$18.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.48 / $23.48 / $26.36	Professional	TC	$23.48	$23.48	$26.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.94 / $55.35 / $72.83	Professional		$14.94	$55.35	$72.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $15.98 / $15.98	Professional	26	$13.58	$15.98	$15.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.39 / $46.34 / $46.34	Professional	TC	$39.39	$46.34	$46.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.27 / $34.57 / $49.59	Professional		$11.27	$34.57	$49.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.13 / $69.03 / $148.94	Professional		$40.13	$69.03	$148.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.44 / $16.69 / $37.25	Professional	26	$10.44	$16.69	$37.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.89 / $52.01 / $112.69	Professional	TC	$28.89	$52.01	$112.69
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $11.98 / $11.98 / $15.09	Facility	26	$11.98	$11.98	$15.09
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $38.76 / $57.45 / $88.70	Professional		$38.76	$57.45	$88.70
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.91 / $12.35 / $27.44	Professional	26	$9.91	$12.35	$27.44
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $29.46 / $37.86 / $61.46	Professional	TC	$29.46	$37.86	$61.46
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 $49.47 / $63.28 / $91.16	Professional		$49.47	$63.28	$91.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.83 / $14.69 / $20.81	Professional	26	$11.83	$14.69	$20.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.54 / $49.26 / $67.95	Professional	TC	$37.54	$49.26	$67.95