Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.00 / $111.00 / $116.55	Facility	26	$111.00	$111.00	$116.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $268.45 / $392.89 / $688.48	Professional		$268.45	$392.89	$688.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.98 / $111.00 / $284.39	Professional	26	$82.98	$111.00	$284.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $171.98 / $295.33 / $508.96	Professional	TC	$171.98	$295.33	$508.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.55 / $225.90 / $236.34	Professional		$213.55	$225.90	$236.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.41 / $85.61 / $138.19	Professional	26	$65.41	$85.61	$138.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.98 / $406.37 / $525.83	Professional		$127.98	$406.37	$525.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $116.35 / $136.88 / $136.88	Professional	26	$116.35	$136.88	$136.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $320.63 / $320.63 / $320.63	Professional	TC	$320.63	$320.63	$320.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.79 / $230.76 / $365.11	Professional		$91.79	$230.76	$365.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.41 / $98.41 / $98.41	Facility	26	$98.41	$98.41	$98.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.89 / $472.82 / $797.73	Professional		$280.89	$472.82	$797.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.16 / $105.11 / $212.79	Professional	26	$65.16	$105.11	$212.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.80 / $330.84 / $663.50	Professional	TC	$192.80	$330.84	$663.50
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $74.97 / $111.00 / $116.55	Facility	26	$74.97	$111.00	$116.55
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $301.00 / $349.61 / $625.24	Professional		$301.00	$349.61	$625.24
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.97 / $111.00 / $273.14	Professional	26	$74.97	$111.00	$273.14
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $211.72 / $274.63 / $393.66	Professional	TC	$211.72	$274.63	$393.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.99 / $169.60 / $301.95	Professional		$93.99	$169.60	$301.95
United Facility/Professional Professional Modifier Low / Median / High Price $289.42 / $426.76 / $614.26	Professional		$289.42	$426.76	$614.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.13 / $99.69 / $150.66	Professional	26	$82.13	$99.69	$150.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $203.99 / $320.41 / $504.13	Professional	TC	$203.99	$320.41	$504.13