Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $84.23	Facility	26	$70.79	$70.79	$84.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.04 / $284.45 / $495.07	Professional		$228.04	$284.45	$495.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.08 / $70.14 / $153.26	Professional	26	$50.08	$70.14	$153.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.14 / $217.46 / $418.64	Professional	TC	$172.14	$217.46	$418.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.60 / $222.36 / $222.36	Professional		$199.60	$222.36	$222.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.09 / $62.16 / $109.44	Professional	26	$44.09	$62.16	$109.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.17 / $291.91 / $393.66	Professional		$81.17	$291.91	$393.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.45 / $198.64 / $292.89	Professional		$58.45	$198.64	$292.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Facility	26	$62.89	$62.89	$62.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.36 / $356.63 / $557.16	Professional		$217.36	$356.63	$557.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.24 / $68.77 / $135.07	Professional	26	$41.24	$68.77	$135.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.91 / $267.80 / $469.66	Professional	TC	$157.91	$267.80	$469.66
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $45.60 / $70.79 / $74.34	Facility	26	$45.60	$70.79	$74.34
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $217.02 / $284.45 / $448.61	Professional		$217.02	$284.45	$448.61
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.60 / $69.95 / $129.54	Professional	26	$45.60	$69.95	$129.54
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $171.43 / $213.65 / $357.09	Professional	TC	$171.43	$213.65	$357.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $184.48 / $277.93	Professional		$34.95	$184.48	$277.93
United Facility/Professional Professional Modifier Low / Median / High Price $222.81 / $274.33 / $403.00	Professional		$222.81	$274.33	$403.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.33 / $62.66 / $158.16	Professional	26	$52.33	$62.66	$158.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.61 / $216.50 / $319.24	Professional	TC	$169.61	$216.50	$319.24