Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.22 / $131.22 / $137.79	Facility	26	$131.22	$131.22	$137.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $394.68 / $496.32 / $738.63	Professional		$394.68	$496.32	$738.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.26 / $140.00 / $391.38	Professional	26	$105.26	$140.00	$391.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $301.49 / $365.10 / $542.08	Professional	TC	$301.49	$365.10	$542.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $230.50 / $230.50 / $275.00	Professional		$230.50	$230.50	$275.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.16 / $101.30 / $145.62	Professional	26	$79.16	$101.30	$145.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $266.39 / $652.00 / $1,394.74	Professional		$266.39	$652.00	$1,394.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $162.44 / $162.44 / $162.44	Professional	26	$162.44	$162.44	$162.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $459.10 / $459.10 / $459.10	Professional	TC	$459.10	$459.10	$459.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.89 / $330.37 / $495.39	Professional		$108.89	$330.37	$495.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $430.67 / $771.31 / $1,251.78	Professional		$430.67	$771.31	$1,251.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.65 / $124.41 / $250.28	Professional	26	$76.65	$124.41	$250.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $336.03 / $558.65 / $1,066.19	Professional	TC	$336.03	$558.65	$1,066.19
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $83.65 / $131.22 / $133.59	Facility	26	$83.65	$131.22	$133.59
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $394.68 / $496.32 / $750.00	Professional		$394.68	$496.32	$750.00
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $83.65 / $137.79 / $389.19	Professional	26	$83.65	$137.79	$389.19
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $330.76 / $411.98 / $576.15	Professional	TC	$330.76	$411.98	$576.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $287.59 / $426.20	Professional		$93.51	$287.59	$426.20
United Facility/Professional Professional Modifier Low / Median / High Price $422.13 / $567.69 / $1,140.15	Professional		$422.13	$567.69	$1,140.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.00 / $112.53 / $177.91	Professional	26	$95.00	$112.53	$177.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $313.77 / $425.71 / $821.93	Professional	TC	$313.77	$425.71	$821.93