Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.97 / $13.97 / $14.66	Facility	26	$13.97	$13.97	$14.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $45.00 / $67.03	Professional		$39.72	$45.00	$67.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $12.34 / $18.77	Professional	26	$10.83	$12.34	$18.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.23 / $32.83 / $48.27	Professional	TC	$28.23	$32.83	$48.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.95 / $41.72 / $76.81	Professional		$36.95	$41.72	$76.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.97 / $13.32 / $21.12	Professional	26	$9.97	$13.32	$21.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.01 / $27.01 / $27.01	Professional	TC	$27.01	$27.01	$27.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.13 / $57.27 / $77.31	Professional		$18.13	$57.27	$77.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.64 / $18.64 / $18.64	Professional	26	$18.64	$18.64	$18.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.14 / $39.35 / $57.06	Professional		$13.14	$39.35	$57.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.99 / $56.85 / $161.32	Professional		$41.99	$56.85	$161.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.61 / $16.35 / $40.63	Professional	26	$11.61	$16.35	$40.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.04 / $41.31 / $120.69	Professional	TC	$30.04	$41.31	$120.69
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.03 / $12.03 / $14.22	Facility	26	$12.03	$12.03	$14.22
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $41.09 / $46.56 / $66.81	Professional		$41.09	$46.56	$66.81
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.24 / $13.12 / $19.61	Professional	26	$11.24	$13.12	$19.61
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $29.06 / $33.28 / $48.42	Professional	TC	$29.06	$33.28	$48.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $33.09 / $47.38	Professional		$26.31	$33.09	$47.38
United Facility/Professional Professional Modifier Low / Median / High Price $39.95 / $48.40 / $67.50	Professional		$39.95	$48.40	$67.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.37 / $14.11 / $20.34	Professional	26	$11.37	$14.11	$20.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.58 / $34.24 / $48.60	Professional	TC	$28.58	$34.24	$48.60