Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.14 / $29.44 / $30.91	Facility	26	$29.14	$29.44	$30.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.37 / $52.33 / $136.55	Professional		$47.37	$52.33	$136.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $29.15 / $44.08	Professional	26	$25.82	$29.15	$44.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $23.83 / $33.90	Professional	TC	$20.70	$23.83	$33.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.06 / $36.67 / $43.14	Professional		$25.06	$36.67	$43.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.02 / $27.97 / $38.00	Professional	26	$22.02	$27.97	$38.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.40 / $62.44 / $78.88	Professional		$23.40	$62.44	$78.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.27 / $45.27 / $45.27	Professional	26	$45.27	$45.27	$45.27
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.28 / $21.28 / $25.03	Professional	TC	$21.28	$21.28	$25.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.42 / $34.49 / $57.05	Professional		$15.42	$34.49	$57.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $39.28 / $87.76	Professional		$39.28	$39.28	$87.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $35.04	Professional	26	$25.29	$25.29	$35.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $13.99 / $25.54	Professional	TC	$13.99	$13.99	$25.54
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $29.44 / $30.91	Facility	26	$22.91	$29.44	$30.91
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $48.46 / $55.52 / $92.36	Professional		$48.46	$55.52	$92.36
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $29.39 / $45.03	Professional	26	$22.91	$29.39	$45.03
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $17.98 / $22.73 / $31.42	Professional	TC	$17.98	$22.73	$31.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $61.81 / $85.10	Professional		$32.34	$61.81	$85.10
United Facility/Professional Professional Modifier Low / Median / High Price $50.35 / $60.74 / $86.90	Professional		$50.35	$60.74	$86.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.96 / $33.15 / $47.29	Professional	26	$27.96	$33.15	$47.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.98 / $27.32 / $38.68	Professional	TC	$21.98	$27.32	$38.68