Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.40 / $111.40 / $140.36	Facility	26	$111.40	$111.40	$140.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $306.68 / $390.06 / $846.45	Professional		$306.68	$390.06	$846.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.01 / $120.54 / $357.00	Professional	26	$81.01	$120.54	$357.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $224.65 / $278.67 / $418.01	Professional	TC	$224.65	$278.67	$418.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $228.01 / $253.53 / $296.94	Professional		$228.01	$253.53	$296.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.95 / $92.52 / $133.30	Professional	26	$66.95	$92.52	$133.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.47 / $395.00 / $509.04	Professional		$128.47	$395.00	$509.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $116.80 / $137.41 / $137.41	Professional	26	$116.80	$137.41	$137.41
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $352.05 / $352.05 / $352.05	Professional	TC	$352.05	$352.05	$352.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $92.14 / $253.32 / $390.53	Professional		$92.14	$253.32	$390.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.40 / $98.40 / $98.40	Facility	26	$98.40	$98.40	$98.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.95 / $417.16 / $732.33	Professional		$257.95	$417.16	$732.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.56 / $104.62 / $213.53	Professional	26	$67.56	$104.62	$213.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $185.01 / $297.52 / $583.12	Professional	TC	$185.01	$297.52	$583.12
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $69.75 / $111.40 / $137.34	Facility	26	$69.75	$111.40	$137.34
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $280.33 / $390.06 / $686.26	Professional		$280.33	$390.06	$686.26
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $69.75 / $111.40 / $343.20	Professional	26	$69.75	$111.40	$343.20
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $210.59 / $278.67 / $418.01	Professional	TC	$210.59	$278.67	$418.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.78 / $227.43 / $354.39	Professional		$93.78	$227.43	$354.39
United Facility/Professional Professional Modifier Low / Median / High Price $299.73 / $355.87 / $500.50	Professional		$299.73	$355.87	$500.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.44 / $97.15 / $150.66	Professional	26	$82.44	$97.15	$150.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.27 / $258.72 / $356.58	Professional	TC	$215.27	$258.72	$356.58