Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.56 / $78.56 / $82.49	Facility	26	$78.56	$78.56	$82.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.56 / $232.78 / $368.92	Professional		$164.56	$232.78	$368.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $77.28 / $103.71	Professional	26	$55.15	$77.28	$103.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.72 / $169.25 / $291.63	Professional	TC	$99.72	$169.25	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.87 / $79.87 / $90.93	Professional		$79.87	$79.87	$90.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.83 / $62.56 / $114.58	Professional	26	$46.83	$62.56	$114.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.62 / $185.56 / $273.10	Professional		$85.62	$185.56	$273.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $96.40 / $96.40 / $96.40	Professional	26	$96.40	$96.40	$96.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.00 / $147.00 / $147.00	Professional	TC	$147.00	$147.00	$147.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.81 / $105.78 / $188.75	Professional		$64.81	$105.78	$188.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.44 / $69.44 / $69.44	Facility	26	$69.44	$69.44	$69.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.18 / $259.66 / $452.89	Professional		$159.18	$259.66	$452.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.30 / $72.51 / $149.96	Professional	26	$46.30	$72.51	$149.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.84 / $170.25 / $311.37	Professional	TC	$96.84	$170.25	$311.37
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $50.09 / $78.56 / $82.49	Facility	26	$50.09	$78.56	$82.49
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $169.06 / $192.62 / $325.23	Professional		$169.06	$192.62	$325.23
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $50.09 / $74.34 / $103.71	Professional	26	$50.09	$74.34	$103.71
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $106.43 / $141.79 / $243.35	Professional	TC	$106.43	$141.79	$243.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $108.90 / $159.69	Professional		$35.58	$108.90	$159.69
United Facility/Professional Professional Modifier Low / Median / High Price $157.03 / $220.57 / $325.37	Professional		$157.03	$220.57	$325.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.15 / $69.17 / $172.89	Professional	26	$58.15	$69.17	$172.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.70 / $152.12 / $224.81	Professional	TC	$98.70	$152.12	$224.81