Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $10.47 / $13.18	Facility	26	$10.47	$10.47	$13.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $186.21	Professional		$51.29	$64.57	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $33.88	Professional	26	$7.94	$10.00	$33.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $39.81 / $39.81 / $39.81	Professional	52	$39.81	$39.81	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $95.50	Professional	TC	$42.66	$52.48	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $57.54 / $100.00	Professional		$46.77	$57.54	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.12 / $15.85	Professional	26	$7.59	$9.12	$15.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $63.10 / $72.44	Professional	TC	$44.67	$63.10	$72.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $83.18 / $89.13	Professional		$77.62	$83.18	$89.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $13.80 / $13.80	Professional	26	$11.75	$13.80	$13.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $64.57 / $75.86	Professional	TC	$64.57	$64.57	$75.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $52.48 / $95.50	Professional		$10.00	$52.48	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $144.54	Professional		$52.48	$70.79	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $23.44	Professional	26	$8.51	$11.48	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $60.26 / $120.23	Professional	TC	$44.67	$60.26	$120.23
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $10.47 / $19.95	Facility	26	$8.71	$10.47	$19.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $120.23	Professional		$52.48	$64.57	$120.23
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $21.88	Professional	26	$7.94	$10.47	$21.88
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $52.48 / $89.13	Professional	TC	$43.65	$52.48	$89.13
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $64.57 / $123.03	Professional		$48.98	$64.57	$123.03
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.72 / $19.50	Professional	26	$8.13	$10.72	$19.50
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $54.95 / $107.15	Professional	TC	$39.81	$54.95	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $61.66 / $89.13	Professional		$51.29	$61.66	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.00 / $14.79	Professional	26	$8.13	$10.00	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $51.29 / $75.86	Professional	TC	$42.66	$51.29	$75.86