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 / $89.20	Facility	26	$70.79	$70.79	$89.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $274.70 / $438.99	Professional		$171.00	$274.70	$438.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $70.79 / $161.16	Professional	26	$50.07	$70.79	$161.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $212.74 / $368.85	Professional	TC	$119.70	$212.74	$368.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.09 / $69.95 / $103.60	Professional	26	$44.09	$69.95	$103.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.17 / $252.48 / $530.21	Professional		$81.17	$252.48	$530.21
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.81 / $86.81 / $86.81	Professional	26	$86.81	$86.81	$86.81
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $183.21 / $183.21 / $183.21	Professional	TC	$183.21	$183.21	$183.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.45 / $131.88 / $215.93	Professional		$58.45	$131.88	$215.93
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 $205.59 / $316.22 / $529.85	Professional		$205.59	$316.22	$529.85
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 $141.41 / $222.17 / $396.58	Professional	TC	$141.41	$222.17	$396.58
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 $182.88 / $225.23 / $390.42	Professional		$182.88	$225.23	$390.42
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.60 / $70.79 / $161.16	Professional	26	$45.60	$70.79	$161.16
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $132.22 / $179.63 / $315.77	Professional	TC	$132.22	$179.63	$315.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $116.15 / $192.46	Professional		$34.95	$116.15	$192.46
United Facility/Professional Professional Modifier Low / Median / High Price $181.82 / $257.00 / $410.42	Professional		$181.82	$257.00	$410.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.33 / $60.12 / $85.56	Professional	26	$52.33	$60.12	$85.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.81 / $192.50 / $275.00	Professional	TC	$125.81	$192.50	$275.00