Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.73 / $77.73 / $81.61	Facility	26	$77.73	$77.73	$81.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.67 / $281.67 / $449.34	Professional		$177.67	$281.67	$449.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $77.73 / $145.79	Professional	26	$54.86	$77.73	$145.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $201.68 / $372.43	Professional	TC	$119.70	$201.68	$372.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.79 / $131.50 / $131.50	Professional		$104.79	$131.50	$131.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.33 / $59.21 / $90.62	Professional	26	$46.33	$59.21	$90.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.38 / $249.78 / $354.96	Professional		$95.38	$249.78	$354.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.34 / $95.34 / $95.34	Professional	26	$95.34	$95.34	$95.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $185.88 / $185.88 / $185.88	Professional	TC	$185.88	$185.88	$185.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $133.80 / $224.95	Professional		$64.09	$133.80	$224.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.24 / $326.95 / $539.25	Professional		$176.24	$326.95	$539.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.07 / $74.14 / $148.37	Professional	26	$46.07	$74.14	$148.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $118.15 / $208.99 / $373.78	Professional	TC	$118.15	$208.99	$373.78
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $49.56 / $77.73 / $80.75	Facility	26	$49.56	$77.73	$80.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $196.37 / $222.35 / $359.64	Professional		$196.37	$222.35	$359.64
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $49.56 / $77.73 / $117.73	Professional	26	$49.56	$77.73	$117.73
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $134.13 / $152.37 / $282.38	Professional	TC	$134.13	$152.37	$282.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $116.15 / $192.46	Professional		$35.58	$116.15	$192.46
United Facility/Professional Professional Modifier Low / Median / High Price $179.58 / $233.86 / $385.55	Professional		$179.58	$233.86	$385.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.57 / $66.84 / $105.44	Professional	26	$56.57	$66.84	$105.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.22 / $167.96 / $297.22	Professional	TC	$118.22	$167.96	$297.22