Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $32.36	Facility	26	$25.70	$25.70	$32.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.02 / $104.71	Professional		$30.90	$38.02	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $25.70 / $87.10	Professional	26	$20.42	$25.70	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $12.02 / $23.99	Professional	TC	$10.00	$12.02	$23.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $33.88 / $61.66	Professional		$27.54	$33.88	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $22.91 / $38.90	Professional	26	$18.62	$22.91	$38.90
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $15.49 / $15.49 / $15.49	Professional	52	$15.49	$15.49	$15.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $51.29 / $54.95	Professional		$46.77	$51.29	$54.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $34.67 / $34.67	Professional	26	$29.51	$34.67	$34.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $20.42 / $20.42	Professional	TC	$17.38	$20.42	$20.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $28.84 / $51.29	Professional		$13.80	$28.84	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $87.10	Professional		$32.36	$41.69	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $28.18 / $60.26	Professional	26	$21.38	$28.18	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $14.79 / $31.62	Professional	TC	$10.72	$14.79	$31.62
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $25.70 / $60.26	Facility	26	$22.91	$25.70	$60.26
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $38.90 / $75.86	Professional		$31.62	$38.90	$75.86
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.70 / $54.95	Professional	26	$20.89	$25.70	$54.95
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $12.88 / $22.39	Professional	TC	$10.00	$12.88	$22.39
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.90 / $74.13	Professional		$29.51	$38.90	$74.13
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $26.92 / $48.98	Professional	26	$20.42	$26.92	$48.98
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.55 / $13.49 / $26.30	Professional	TC	$9.55	$13.49	$26.30
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.02 / $54.95	Professional		$30.90	$38.02	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.70 / $38.02	Professional	26	$20.89	$25.70	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $12.59 / $18.20	Professional	TC	$9.77	$12.59	$18.20