Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $46.70	Facility	26	$37.07	$37.07	$46.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.59 / $100.59 / $296.76	Professional		$82.59	$100.59	$296.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.75 / $40.07 / $171.20	Professional	26	$27.75	$40.07	$171.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.17 / $62.21 / $117.35	Professional	TC	$48.17	$62.21	$117.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.42 / $78.48 / $110.28	Professional		$60.42	$78.48	$110.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.80 / $30.41 / $54.74	Professional	26	$23.80	$30.41	$54.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.29 / $44.29 / $44.29	Professional	TC	$44.29	$44.29	$44.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.53 / $100.85 / $134.05	Professional		$43.53	$100.85	$134.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.65 / $49.00 / $49.00	Professional	26	$41.65	$49.00	$49.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.91 / $79.89 / $79.89	Professional	TC	$67.91	$79.89	$79.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.95 / $57.51 / $97.32	Professional		$32.95	$57.51	$97.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.11 / $35.11 / $35.11	Facility	26	$35.11	$35.11	$35.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.50 / $103.20 / $218.81	Professional		$68.50	$103.20	$218.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.73 / $37.94 / $91.31	Professional	26	$24.73	$37.94	$91.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.13 / $64.58 / $144.85	Professional	TC	$42.13	$64.58	$144.85
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $24.53 / $37.07 / $41.11	Facility	26	$24.53	$37.07	$41.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $72.90 / $94.18 / $187.16	Professional		$72.90	$94.18	$187.16
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.53 / $38.01 / $115.97	Professional	26	$24.53	$38.01	$115.97
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $48.37 / $57.39 / $100.74	Professional	TC	$48.37	$57.39	$100.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $47.07 / $121.29	Professional		$28.64	$47.07	$121.29
United Facility/Professional Professional Modifier Low / Median / High Price $77.98 / $95.14 / $135.12	Professional		$77.98	$95.14	$135.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.15 / $34.60 / $47.24	Professional	26	$28.15	$34.60	$47.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.62 / $58.67 / $80.67	Professional	TC	$46.62	$58.67	$80.67