Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $478.63 / $676.08	Facility		$85.11	$478.63	$676.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $48.98 / $48.98	Facility	26	$46.77	$48.98	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $97.72 / $426.58	Professional		$56.23	$97.72	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $52.48 / $169.82	Professional	26	$30.90	$52.48	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $37.15 / $173.78	Professional	TC	$25.12	$37.15	$173.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $27.54 / $63.10	Professional		$23.44	$27.54	$63.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $46.77 / $50.12	Professional	26	$36.31	$46.77	$50.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $95.50 / $95.50	Facility		$41.69	$95.50	$95.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $87.10 / $95.50	Professional		$53.70	$87.10	$95.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $48.98 / $57.54	Professional	26	$48.98	$48.98	$57.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $37.15 / $44.67	Professional	TC	$37.15	$37.15	$44.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $52.48 / $128.82	Facility		$32.36	$52.48	$128.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $44.67 / $81.28	Professional		$26.92	$44.67	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $43.65 / $63.10	Facility	26	$9.33	$43.65	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $144.54 / $331.13	Professional		$67.61	$144.54	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $75.86 / $158.49	Professional	26	$38.90	$75.86	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $64.57 / $204.17	Professional	TC	$29.51	$64.57	$204.17
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $478.63 / $575.44	Facility		$85.11	$478.63	$575.44
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $190.55 / $229.09	Facility	26	$46.77	$190.55	$229.09
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $107.15 / $295.12	Professional		$61.66	$107.15	$295.12
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $60.26 / $117.49	Professional	26	$36.31	$60.26	$117.49
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $44.67 / $169.82	Professional	TC	$26.92	$44.67	$169.82
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $43.65 / $63.10	Facility	26	$9.33	$43.65	$63.10
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $169.82 / $478.63	Professional		$66.07	$169.82	$478.63
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $74.13 / $158.49	Professional	26	$37.15	$74.13	$158.49
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $104.71 / $281.84	Professional	TC	$28.84	$104.71	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $831.76 / $1,862.09	Facility		$123.03	$831.76	$1,862.09
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $181.97 / $275.42	Professional		$66.07	$181.97	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $74.13 / $112.20	Professional	26	$38.02	$74.13	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $100.00 / $173.78	Professional	TC	$28.18	$100.00	$173.78