Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.06 / $85.06 / $89.31	Facility	26	$85.06	$85.06	$89.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.67 / $366.58 / $634.12	Professional		$239.67	$366.58	$634.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $84.60 / $138.13	Professional	26	$60.39	$84.60	$138.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.46 / $306.18 / $502.82	Professional	TC	$172.46	$306.18	$502.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $195.19 / $240.59 / $240.59	Professional		$195.19	$240.59	$240.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.67 / $62.30 / $124.60	Professional	26	$50.67	$62.30	$124.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.60 / $333.97 / $471.49	Professional		$97.60	$333.97	$471.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.73 / $104.39 / $104.39	Professional	26	$88.73	$104.39	$104.39
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $315.83 / $315.83 / $315.83	Professional	TC	$315.83	$315.83	$315.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.31 / $227.27 / $335.17	Professional		$70.31	$227.27	$335.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.64 / $75.64 / $75.64	Facility	26	$75.64	$75.64	$75.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.93 / $430.10 / $788.89	Professional		$252.93	$430.10	$788.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.76 / $82.33 / $164.43	Professional	26	$50.76	$82.33	$164.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.99 / $313.87 / $567.95	Professional	TC	$181.99	$313.87	$567.95
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $54.80 / $85.06 / $89.31	Facility	26	$54.80	$85.06	$89.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $279.93 / $327.83 / $521.54	Professional		$279.93	$327.83	$521.54
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.80 / $82.56 / $129.00	Professional	26	$54.80	$82.56	$129.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $211.06 / $273.05 / $382.27	Professional	TC	$211.06	$273.05	$382.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.71 / $164.14 / $265.78	Professional		$61.71	$164.14	$265.78
United Facility/Professional Professional Modifier Low / Median / High Price $259.58 / $327.73 / $534.79	Professional		$259.58	$327.73	$534.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.01 / $73.40 / $115.90	Professional	26	$62.01	$73.40	$115.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.10 / $251.64 / $422.96	Professional	TC	$192.10	$251.64	$422.96