Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.28 / $34.57 / $43.20	Facility	26	$34.28	$34.57	$43.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.64 / $56.88 / $114.95	Professional		$43.64	$56.88	$114.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.62 / $34.58 / $78.86	Professional	26	$26.62	$34.58	$78.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $50.81 / $56.15	Professional		$39.36	$50.81	$56.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.12 / $40.46 / $42.01	Professional	26	$31.12	$40.46	$42.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.56 / $43.33 / $78.81	Professional		$13.56	$43.33	$78.81
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.39 / $46.34 / $46.34	Professional	26	$39.39	$46.34	$46.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.95 / $31.81 / $56.55	Professional		$18.95	$31.81	$56.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.75 / $50.01 / $142.35	Professional		$41.75	$50.01	$142.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.26 / $35.49 / $57.22	Professional	26	$26.26	$35.49	$57.22
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $31.82 / $34.57 / $43.20	Facility	26	$31.82	$34.57	$43.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $49.75 / $56.88 / $92.63	Professional		$49.75	$56.88	$92.63
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $31.12 / $36.72 / $76.16	Professional	26	$31.12	$36.72	$76.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $46.76 / $80.78	Professional		$28.70	$46.76	$80.78
United Facility/Professional Professional Modifier Low / Median / High Price $50.85 / $60.21 / $78.97	Professional		$50.85	$60.21	$78.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.47 / $38.00 / $49.78	Professional	26	$32.47	$38.00	$49.78