Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.87 / $139.87 / $146.87	Facility	26	$139.87	$139.87	$146.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $353.49 / $475.00 / $688.75	Professional		$353.49	$475.00	$688.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.29 / $143.11 / $475.85	Professional	26	$112.29	$143.11	$475.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $238.22 / $335.00 / $462.42	Professional	TC	$238.22	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $250.72 / $256.48 / $313.95	Professional		$250.72	$256.48	$313.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $86.65 / $108.19 / $205.70	Professional	26	$86.65	$108.19	$205.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $168.32 / $460.78 / $654.79	Professional		$168.32	$460.78	$654.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $116.00 / $248.77 / $414.54	Professional		$116.00	$248.77	$414.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.86 / $686.14 / $1,225.33	Professional		$344.86	$686.14	$1,225.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.10 / $146.22 / $267.92	Professional	26	$85.10	$146.22	$267.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $244.94 / $431.96 / $1,067.46	Professional	TC	$244.94	$431.96	$1,067.46
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $100.86 / $139.87 / $146.87	Facility	26	$100.86	$139.87	$146.87
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $371.75 / $494.24 / $738.63	Professional		$371.75	$494.24	$738.63
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $100.86 / $140.00 / $471.25	Professional	26	$100.86	$140.00	$471.25
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $250.16 / $335.00 / $502.01	Professional	TC	$250.16	$335.00	$502.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $198.34 / $337.76	Professional		$93.51	$198.34	$337.76
United Facility/Professional Professional Modifier Low / Median / High Price $349.20 / $596.00 / $1,002.05	Professional		$349.20	$596.00	$1,002.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.04 / $128.63 / $189.51	Professional	26	$107.04	$128.63	$189.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $232.82 / $307.95 / $838.05	Professional	TC	$232.82	$307.95	$838.05