Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $134.90	Facility	26	$107.15	$107.15	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $338.84 / $1,096.48	Professional		$158.49	$338.84	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $158.49 / $354.81	Professional	26	$77.62	$158.49	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $190.55 / $323.59	Professional		$138.04	$190.55	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $89.13 / $117.49	Professional	26	$87.10	$89.13	$117.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $263.03 / $281.84	Professional		$147.91	$263.03	$281.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Professional	26	$141.25	$141.25	$141.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $120.23 / $223.87	Professional		$85.11	$120.23	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $102.33 / $144.54	Facility	26	$21.88	$102.33	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $239.88 / $489.78	Professional		$144.54	$239.88	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $114.82 / $257.04	Professional	26	$72.44	$114.82	$257.04
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $112.20 / $213.80	Facility	26	$107.15	$112.20	$213.80
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $239.88 / $724.44	Professional		$151.36	$239.88	$724.44
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $114.82 / $275.42	Professional	26	$77.62	$114.82	$275.42
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $102.33 / $144.54	Facility	26	$21.88	$102.33	$144.54
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $199.53 / $407.38	Professional		$144.54	$199.53	$407.38
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $102.33 / $199.53	Professional	26	$63.10	$102.33	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $208.93 / $288.40	Professional		$165.96	$208.93	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $100.00 / $141.25	Professional	26	$81.28	$100.00	$141.25