Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.86 / $35.86 / $45.19	Facility	26	$35.86	$35.86	$45.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.51 / $109.24 / $182.25	Professional		$66.51	$109.24	$182.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $35.86 / $55.00	Professional	26	$24.78	$35.86	$55.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.50 / $86.18 / $133.80	Professional	TC	$42.50	$86.18	$133.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.26 / $27.18 / $52.18	Professional	26	$21.26	$27.18	$52.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.83 / $144.77 / $182.87	Professional		$40.83	$144.77	$182.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.67 / $43.67 / $43.67	Professional	26	$43.67	$43.67	$43.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.31 / $85.92 / $129.75	Professional		$29.31	$85.92	$129.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.74 / $133.57 / $272.47	Professional		$86.74	$133.57	$272.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.25 / $32.25 / $67.69	Professional	26	$21.25	$32.25	$67.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.78 / $93.06 / $193.71	Professional	TC	$60.78	$93.06	$193.71
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $21.36 / $35.86 / $37.65	Facility	26	$21.36	$35.86	$37.65
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $111.65 / $197.46	Professional		$73.48	$111.65	$197.46
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $21.36 / $33.29 / $57.70	Professional	26	$21.36	$33.29	$57.70
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $50.00 / $86.18 / $138.47	Professional	TC	$50.00	$86.18	$138.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $76.59 / $117.12	Professional		$34.95	$76.59	$117.12
United Facility/Professional Professional Modifier Low / Median / High Price $82.29 / $106.46 / $158.16	Professional		$82.29	$106.46	$158.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.75 / $29.59 / $45.38	Professional	26	$24.75	$29.59	$45.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.44 / $76.87 / $110.63	Professional	TC	$59.44	$76.87	$110.63