Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.10 / $85.24 / $263.47	Facility		$41.10	$85.24	$263.47
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.72 / $12.72 / $16.02	Facility	26	$12.72	$12.72	$16.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $41.29 / $66.50	Professional		$29.19	$41.29	$66.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $12.72 / $53.96	Professional	26	$9.41	$12.72	$53.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $29.32 / $44.93	Professional	TC	$19.76	$29.32	$44.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.23 / $30.33 / $35.68	Professional		$28.23	$30.33	$35.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.26 / $13.73 / $20.79	Professional	26	$8.26	$13.73	$20.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.51 / $61.88 / $107.55	Facility		$43.51	$61.88	$107.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.91 / $46.61 / $60.26	Professional		$19.91	$46.61	$60.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.04 / $17.04 / $17.04	Professional	26	$17.04	$17.04	$17.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.31 / $41.54 / $41.54	Professional	TC	$35.31	$41.54	$41.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $26.83 / $44.94	Facility		$10.23	$26.83	$44.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.45 / $29.93 / $46.64	Professional		$11.45	$29.93	$46.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $41.01 / $41.01	Facility		$41.01	$41.01	$41.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.37 / $42.59 / $78.55	Professional		$27.37	$42.59	$78.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.33 / $13.58 / $26.30	Professional	26	$8.33	$13.58	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $29.83 / $54.91	Professional	TC	$17.73	$29.83	$54.91
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $41.10 / $150.83 / $318.01	Facility		$41.10	$150.83	$318.01
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.66 / $12.72 / $13.35	Facility	26	$8.66	$12.72	$13.35
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $26.34 / $42.04 / $65.93	Professional		$26.34	$42.04	$65.93
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $12.72 / $27.74	Professional	26	$8.66	$12.72	$27.74
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $17.67 / $29.32 / $44.00	Professional	TC	$17.67	$29.32	$44.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $32.80 / $45.08	Professional		$26.17	$32.80	$45.08
United Facility/Professional Facility Modifier Low / Median / High Price $80.90 / $80.90 / $80.90	Facility		$80.90	$80.90	$80.90
United Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $34.99 / $51.79	Professional		$30.00	$34.99	$51.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.75 / $12.38 / $60.85	Professional	26	$9.75	$12.38	$60.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.87 / $23.38 / $33.28	Professional	TC	$19.87	$23.38	$33.28