Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.14 / $24.14 / $24.14	Facility	26	$24.14	$24.14	$24.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.02 / $79.77 / $127.89	Professional		$67.02	$79.77	$127.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $24.14 / $46.77	Professional	26	$17.82	$24.14	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.07 / $59.30 / $72.83	Professional	TC	$48.07	$59.30	$72.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.31 / $73.31 / $84.08	Professional		$73.31	$73.31	$84.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.45 / $27.62 / $29.34	Professional	26	$20.45	$27.62	$29.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.87 / $98.60 / $118.69	Professional		$30.87	$98.60	$118.69
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.07 / $28.07 / $33.02	Professional	26	$28.07	$28.07	$33.02
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.88 / $87.88 / $87.88	Professional	TC	$87.88	$87.88	$87.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $69.23 / $112.20	Professional		$29.00	$69.23	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $253.55	Professional		$67.55	$67.55	$253.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $22.93	Professional	26	$18.45	$18.45	$22.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $57.48	Professional	TC	$49.10	$49.10	$57.48
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $15.36 / $15.36 / $24.14	Facility	26	$15.36	$15.36	$24.14
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $56.56 / $72.52 / $102.93	Professional		$56.56	$72.52	$102.93
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $15.36 / $21.69 / $45.41	Professional	26	$15.36	$21.69	$45.41
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $41.20 / $53.90 / $72.83	Professional	TC	$41.20	$53.90	$72.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.89 / $65.20 / $88.68	Professional		$53.89	$65.20	$88.68
United Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $103.25 / $164.23	Professional		$73.00	$103.25	$164.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.70 / $23.81 / $28.92	Professional	26	$17.70	$23.81	$28.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.40 / $73.17 / $136.46	Professional	TC	$52.40	$73.17	$136.46