Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.75 / $16.75 / $16.75	Facility	26	$16.75	$16.75	$16.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.61 / $39.56 / $65.01	Professional		$34.61	$39.56	$65.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $15.02 / $23.10	Professional	26	$12.80	$15.02	$23.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.86 / $25.10 / $37.68	Professional	TC	$21.86	$25.10	$37.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.21 / $35.22 / $66.62	Professional		$32.21	$35.22	$66.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.98 / $13.80 / $25.29	Professional	26	$11.98	$13.80	$25.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.92 / $52.96 / $65.83	Professional		$20.92	$52.96	$65.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.01 / $22.37 / $22.37	Professional	26	$19.01	$22.37	$22.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.80 / $29.89 / $49.55	Professional		$15.80	$29.89	$49.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $48.93 / $139.81	Professional		$36.54	$48.93	$139.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.94 / $18.77 / $48.99	Professional	26	$13.94	$18.77	$48.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.25 / $30.17 / $90.82	Professional	TC	$22.25	$30.17	$90.82
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.32 / $14.32 / $16.75	Facility	26	$14.32	$14.32	$16.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $35.99 / $42.34 / $64.53	Professional		$35.99	$42.34	$64.53
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $15.72 / $23.87	Professional	26	$13.69	$15.72	$23.87
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.78 / $26.22 / $35.86	Professional	TC	$22.78	$26.22	$35.86
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 $35.49 / $43.11 / $61.15	Professional		$35.49	$43.11	$61.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.52 / $16.68 / $25.15	Professional	26	$13.52	$16.68	$25.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.17 / $26.07 / $38.34	Professional	TC	$21.17	$26.07	$38.34