Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.34 / $48.34 / $50.75	Facility	26	$48.34	$48.34	$50.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.37 / $94.56 / $205.19	Professional		$80.37	$94.56	$205.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $41.56 / $119.73	Professional	26	$35.61	$41.56	$119.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.57 / $56.22 / $115.58	Professional	TC	$40.57	$56.22	$115.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.77 / $61.98 / $77.76	Professional		$49.77	$61.98	$77.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.27 / $37.10 / $53.43	Professional	26	$30.27	$37.10	$53.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.98 / $75.29 / $130.37	Professional		$52.98	$75.29	$130.37
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.70 / $59.65 / $59.65	Professional	26	$50.70	$59.65	$59.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.11 / $67.11 / $67.11	Professional	TC	$67.11	$67.11	$67.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.21 / $50.44 / $99.02	Professional		$37.21	$50.44	$99.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.19 / $43.19 / $43.19	Facility	26	$43.19	$43.19	$43.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $114.25 / $214.43	Professional		$63.00	$114.25	$214.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.16 / $48.31 / $93.46	Professional	26	$29.16	$48.31	$93.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.88 / $57.10 / $158.22	Professional	TC	$29.88	$57.10	$158.22
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $30.70 / $48.34 / $49.21	Facility	26	$30.70	$48.34	$49.21
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $69.02 / $94.56 / $174.28	Professional		$69.02	$94.56	$174.28
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.70 / $41.97 / $104.89	Professional	26	$30.70	$41.97	$104.89
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $38.31 / $48.34 / $85.53	Professional	TC	$38.31	$48.34	$85.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $44.54 / $117.12	Professional		$28.18	$44.54	$117.12
United Facility/Professional Professional Modifier Low / Median / High Price $70.48 / $91.13 / $161.18	Professional		$70.48	$91.13	$161.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.00 / $42.28 / $66.43	Professional	26	$35.00	$42.28	$66.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.94 / $44.66 / $100.09	Professional	TC	$29.94	$44.66	$100.09