Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.47 / $39.47 / $39.47	Facility	26	$39.47	$39.47	$39.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.28 / $117.76 / $181.31	Professional		$99.28	$117.76	$181.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.80 / $35.77 / $85.14	Professional	26	$30.80	$35.77	$85.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.67 / $81.98 / $130.10	Professional	TC	$68.67	$81.98	$130.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.71 / $32.90 / $47.30	Professional	26	$25.71	$32.90	$47.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.30 / $153.27 / $185.54	Professional		$49.30	$153.27	$185.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.82 / $52.73 / $52.73	Professional	26	$44.82	$52.73	$52.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.34 / $86.24 / $137.74	Professional		$35.34	$86.24	$137.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.05 / $129.13 / $233.02	Professional		$85.05	$129.13	$233.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.35 / $40.84 / $81.53	Professional	26	$26.35	$40.84	$81.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.25 / $90.76 / $162.07	Professional	TC	$61.25	$90.76	$162.07
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $27.55 / $39.47 / $40.19	Facility	26	$27.55	$39.47	$40.19
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $84.11 / $116.82 / $178.33	Professional		$84.11	$116.82	$178.33
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.55 / $37.15 / $78.06	Professional	26	$27.55	$37.15	$78.06
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $56.56 / $79.66 / $122.40	Professional	TC	$56.56	$79.66	$122.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $76.71 / $117.12	Professional		$34.95	$76.71	$117.12
United Facility/Professional Professional Modifier Low / Median / High Price $94.82 / $114.44 / $181.01	Professional		$94.82	$114.44	$181.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.09 / $38.58 / $57.37	Professional	26	$31.09	$38.58	$57.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.69 / $78.62 / $121.23	Professional	TC	$65.69	$78.62	$121.23