Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.23 / $99.23 / $104.20	Facility	26	$99.23	$99.23	$104.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $327.85 / $475.00 / $822.71	Professional		$327.85	$475.00	$822.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.44 / $125.04 / $353.40	Professional	26	$78.44	$125.04	$353.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.53 / $335.00 / $453.21	Professional	TC	$249.53	$335.00	$453.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.13 / $153.13 / $228.80	Professional		$153.13	$153.13	$228.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.17 / $75.58 / $154.55	Professional	26	$59.17	$75.58	$154.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.55 / $638.66 / $1,012.39	Professional		$142.55	$638.66	$1,012.39
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.67 / $121.97 / $121.97	Professional	26	$103.67	$121.97	$121.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $384.00 / $384.00 / $384.00	Professional	TC	$384.00	$384.00	$384.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $82.10 / $273.64 / $403.26	Professional		$82.10	$273.64	$403.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.95 / $87.95 / $87.95	Facility	26	$87.95	$87.95	$87.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $349.26 / $583.34 / $942.21	Professional		$349.26	$583.34	$942.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.17 / $94.77 / $191.47	Professional	26	$59.17	$94.77	$191.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $265.27 / $447.53 / $785.76	Professional	TC	$265.27	$447.53	$785.76
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $64.39 / $99.23 / $104.20	Facility	26	$64.39	$99.23	$104.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $340.96 / $401.98 / $637.50	Professional		$340.96	$401.98	$637.50
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $64.39 / $99.24 / $268.30	Professional	26	$64.39	$99.24	$268.30
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $276.79 / $330.74 / $499.00	Professional	TC	$276.79	$330.74	$499.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $230.23 / $378.52	Professional		$93.51	$230.23	$378.52
United Facility/Professional Professional Modifier Low / Median / High Price $338.39 / $450.23 / $707.08	Professional		$338.39	$450.23	$707.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.11 / $85.20 / $134.43	Professional	26	$72.11	$85.20	$134.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $259.51 / $350.98 / $567.78	Professional	TC	$259.51	$350.98	$567.78