Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $156.66 / $156.66 / $164.50	Facility	26	$156.66	$156.66	$164.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $381.90 / $475.00 / $714.63	Professional		$381.90	$475.00	$714.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.19 / $156.66 / $409.65	Professional	26	$124.19	$156.66	$409.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $258.95 / $335.00 / $499.00	Professional	TC	$258.95	$335.00	$499.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $94.21 / $162.49 / $230.56	Professional	26	$94.21	$162.49	$230.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.27 / $492.78 / $607.63	Professional		$181.27	$492.78	$607.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $164.79 / $193.87 / $193.87	Professional	26	$164.79	$193.87	$193.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $130.43 / $280.95 / $467.56	Professional		$130.43	$280.95	$467.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $385.62 / $700.00 / $1,154.27	Professional		$385.62	$700.00	$1,154.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.40 / $150.68 / $297.16	Professional	26	$91.40	$150.68	$297.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $273.57 / $477.18 / $808.07	Professional	TC	$273.57	$477.18	$808.07
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $101.42 / $156.66 / $164.50	Facility	26	$101.42	$156.66	$164.50
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $408.44 / $475.00 / $712.30	Professional		$408.44	$475.00	$712.30
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $101.42 / $156.66 / $395.04	Professional	26	$101.42	$156.66	$395.04
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $281.38 / $335.76 / $565.12	Professional	TC	$281.38	$335.76	$565.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $125.14 / $232.60 / $409.18	Professional		$125.14	$232.60	$409.18
United Facility/Professional Professional Modifier Low / Median / High Price $383.92 / $494.04 / $782.03	Professional		$383.92	$494.04	$782.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $115.86 / $138.66 / $211.63	Professional	26	$115.86	$138.66	$211.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.47 / $355.56 / $607.47	Professional	TC	$263.47	$355.56	$607.47