Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $145.05 / $145.05 / $152.30	Facility	26	$145.05	$145.05	$152.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.79 / $371.25 / $702.26	Professional		$286.79	$371.25	$702.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.31 / $145.05 / $355.28	Professional	26	$100.31	$145.05	$355.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $171.98 / $235.21 / $406.13	Professional	TC	$171.98	$235.21	$406.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $195.44 / $253.49 / $253.49	Professional		$195.44	$253.49	$253.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $89.55 / $111.64 / $214.46	Professional	26	$89.55	$111.64	$214.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.31 / $404.26 / $545.04	Professional		$178.31	$404.26	$545.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $179.49 / $179.49 / $179.49	Professional	26	$179.49	$179.49	$179.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.59 / $248.05 / $419.14	Professional		$120.59	$248.05	$419.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.94 / $128.94 / $128.94	Facility	26	$128.94	$128.94	$128.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.48 / $577.40 / $982.26	Professional		$315.48	$577.40	$982.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.34 / $131.94 / $275.83	Professional	26	$84.34	$131.94	$275.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.00 / $397.93 / $727.80	Professional	TC	$210.00	$397.93	$727.80
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $89.96 / $145.05 / $152.30	Facility	26	$89.96	$145.05	$152.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $339.00 / $368.18 / $580.70	Professional		$339.00	$368.18	$580.70
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $89.96 / $145.05 / $314.75	Professional	26	$89.96	$145.05	$314.75
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $213.71 / $272.77 / $406.13	Professional	TC	$213.71	$272.77	$406.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.78 / $198.54 / $341.82	Professional		$93.78	$198.54	$341.82
United Facility/Professional Professional Modifier Low / Median / High Price $348.51 / $548.39 / $715.61	Professional		$348.51	$548.39	$715.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.96 / $122.80 / $194.46	Professional	26	$103.96	$122.80	$194.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $224.15 / $342.49 / $581.45	Professional	TC	$224.15	$342.49	$581.45