Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.39 / $60.39 / $64.56	Facility	26	$60.39	$60.39	$64.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.75 / $221.75 / $382.75	Professional		$140.75	$221.75	$382.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.45 / $60.40 / $198.00	Professional	26	$45.45	$60.40	$198.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.32 / $159.68 / $291.63	Professional	TC	$91.32	$159.68	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.15 / $127.39 / $127.39	Professional		$78.15	$127.39	$127.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $46.15 / $81.50	Professional	26	$36.15	$46.15	$81.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.80 / $58.80 / $58.80	Professional	TC	$58.80	$58.80	$58.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.70 / $170.76 / $218.23	Professional		$69.70	$170.76	$218.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.56 / $74.56 / $74.56	Professional	26	$74.56	$74.56	$74.56
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $135.28 / $135.28 / $135.28	Professional	TC	$135.28	$135.28	$135.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.27 / $97.36 / $164.55	Professional		$50.27	$97.36	$164.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.12 / $276.88 / $445.84	Professional		$156.12	$276.88	$445.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.96 / $64.14 / $117.12	Professional	26	$36.96	$64.14	$117.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.89 / $171.19 / $308.51	Professional	TC	$105.89	$171.19	$308.51
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $39.10 / $60.39 / $64.56	Facility	26	$39.10	$60.39	$64.56
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $149.71 / $184.06 / $338.62	Professional		$149.71	$184.06	$338.62
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $39.10 / $60.39 / $184.83	Professional	26	$39.10	$60.39	$184.83
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $97.93 / $144.96 / $242.00	Professional	TC	$97.93	$144.96	$242.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $108.90 / $159.69	Professional		$34.95	$108.90	$159.69
United Facility/Professional Professional Modifier Low / Median / High Price $144.02 / $213.46 / $314.73	Professional		$144.02	$213.46	$314.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.14 / $55.92 / $78.51	Professional	26	$48.14	$55.92	$78.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.05 / $152.25 / $248.49	Professional	TC	$94.05	$152.25	$248.49