Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.37 / $73.37 / $77.03	Facility	26	$73.37	$73.37	$77.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.15 / $392.48 / $598.50	Professional		$246.15	$392.48	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $113.02 / $266.64	Professional	26	$62.50	$113.02	$266.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $306.33 / $422.10	Professional	TC	$187.50	$306.33	$422.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $106.70	Professional		$106.70	$106.70	$106.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.41 / $53.38 / $106.76	Professional	26	$43.41	$53.38	$106.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.66 / $310.35 / $392.02	Professional		$83.66	$310.35	$392.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.48 / $89.48 / $89.48	Professional	26	$89.48	$89.48	$89.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.28 / $187.10 / $278.52	Professional		$60.28	$187.10	$278.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $273.33 / $469.14 / $885.29	Professional		$273.33	$469.14	$885.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.64 / $69.61 / $140.24	Professional	26	$43.64	$69.61	$140.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.05 / $344.64 / $604.33	Professional	TC	$208.05	$344.64	$604.33
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.92 / $73.37 / $77.03	Facility	26	$46.92	$73.37	$77.03
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $403.85 / $552.20	Professional		$250.00	$403.85	$552.20
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.92 / $77.03 / $191.25	Professional	26	$46.92	$77.03	$191.25
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $187.97 / $308.00 / $441.00	Professional	TC	$187.97	$308.00	$441.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $171.84 / $242.59	Professional		$35.58	$171.84	$242.59
United Facility/Professional Professional Modifier Low / Median / High Price $240.65 / $442.99 / $609.11	Professional		$240.65	$442.99	$609.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.67 / $62.88 / $99.66	Professional	26	$52.67	$62.88	$99.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.63 / $370.51 / $584.66	Professional	TC	$180.63	$370.51	$584.66