Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.84 / $133.84 / $168.63	Facility	26	$133.84	$133.84	$168.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.25 / $475.00 / $879.80	Professional		$374.25	$475.00	$879.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.75 / $140.00 / $479.00	Professional	26	$105.75	$140.00	$479.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $247.54 / $335.00 / $525.90	Professional	TC	$247.54	$335.00	$525.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $203.62 / $255.52 / $270.38	Professional		$203.62	$255.52	$270.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.70 / $103.59 / $210.27	Professional	26	$80.70	$103.59	$210.27
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $311.19 / $311.19 / $311.19	Professional	TC	$311.19	$311.19	$311.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.06 / $465.38 / $691.09	Professional		$161.06	$465.38	$691.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $140.79 / $165.64 / $165.64	Professional	26	$140.79	$165.64	$165.64
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $381.87 / $381.87 / $381.87	Professional	TC	$381.87	$381.87	$381.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $111.10 / $274.82 / $437.13	Professional		$111.10	$274.82	$437.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $397.36 / $736.00 / $1,250.01	Professional		$397.36	$736.00	$1,250.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.08 / $127.77 / $255.24	Professional	26	$78.08	$127.77	$255.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $279.95 / $506.83 / $1,045.65	Professional	TC	$279.95	$506.83	$1,045.65
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $87.61 / $133.84 / $163.89	Facility	26	$87.61	$133.84	$163.89
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $383.76 / $522.62 / $820.95	Professional		$383.76	$522.62	$820.95
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $87.61 / $133.84 / $386.40	Professional	26	$87.61	$133.84	$386.40
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $276.43 / $362.02 / $576.88	Professional	TC	$276.43	$362.02	$576.88
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 $365.98 / $586.38 / $1,093.05	Professional		$365.98	$586.38	$1,093.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.98 / $116.33 / $187.18	Professional	26	$99.98	$116.33	$187.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.08 / $441.81 / $969.96	Professional	TC	$257.08	$441.81	$969.96