Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $28.84 / $36.31	Facility	26	$28.84	$28.84	$36.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $91.20 / $218.78	Professional		$51.29	$91.20	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $36.31 / $95.50	Professional	26	$18.20	$36.31	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.99 / $34.67	Professional	26	$19.05	$23.99	$34.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $117.49 / $125.89	Professional		$79.43	$117.49	$125.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $38.90 / $52.48	Professional	26	$38.90	$38.90	$52.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $64.57 / $107.15	Professional		$26.92	$64.57	$107.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	26	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $245.47	Professional		$70.79	$123.03	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $29.51 / $69.18	Professional	26	$16.98	$29.51	$69.18
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $29.51 / $42.66	Facility	26	$28.18	$29.51	$42.66
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $218.78	Professional		$72.44	$104.71	$218.78
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $28.84 / $75.86	Professional	26	$16.22	$28.84	$75.86
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	26	$6.03	$28.18	$39.81
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $112.20 / $257.04	Professional		$63.10	$112.20	$257.04
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $23.99 / $64.57	Professional	26	$14.79	$23.99	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $120.23 / $309.03	Professional		$70.79	$120.23	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $22.91 / $36.31	Professional	26	$17.38	$22.91	$36.31