Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.69 / $28.69 / $30.12	Facility	26	$28.69	$28.69	$30.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.16 / $130.99 / $207.10	Professional		$67.16	$130.99	$207.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.28 / $28.69 / $80.52	Professional	26	$16.28	$28.69	$80.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.11 / $28.85 / $35.11	Professional	26	$5.11	$28.85	$35.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.35 / $108.24 / $139.84	Professional		$36.35	$108.24	$139.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.04 / $38.88 / $38.88	Professional	26	$33.04	$38.88	$38.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $61.72 / $99.64	Professional		$26.22	$61.72	$99.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.80 / $27.80 / $27.80	Facility	26	$27.80	$27.80	$27.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $120.97 / $232.94	Professional		$70.73	$120.97	$232.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.67 / $26.65 / $59.35	Professional	26	$16.67	$26.65	$59.35
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.63 / $28.69 / $29.79	Facility	26	$14.63	$28.69	$29.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $82.66 / $97.09 / $190.22	Professional		$82.66	$97.09	$190.22
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.63 / $28.69 / $77.45	Professional	26	$14.63	$28.69	$77.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.19 / $77.53 / $119.03	Professional		$35.19	$77.53	$119.03
United Facility/Professional Professional Modifier Low / Median / High Price $71.31 / $121.22 / $420.65	Professional		$71.31	$121.22	$420.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.64 / $22.08 / $33.06	Professional	26	$16.64	$22.08	$33.06