Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.67 / $47.67 / $60.06	Facility	26	$47.67	$47.67	$60.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.43 / $134.38 / $350.66	Professional		$93.43	$134.38	$350.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $50.05 / $186.12	Professional	26	$36.61	$50.05	$186.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.82 / $77.48 / $128.80	Professional	TC	$56.82	$77.48	$128.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.78 / $108.17 / $188.69	Professional		$80.78	$108.17	$188.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.06 / $47.05 / $70.58	Professional	26	$32.06	$47.05	$70.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $55.92 / $60.49 / $108.88	Professional	TC	$55.92	$60.49	$108.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.76 / $147.13 / $186.13	Professional		$59.76	$147.13	$186.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.32 / $63.91 / $63.91	Professional	26	$54.32	$63.91	$63.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.80 / $109.18 / $109.18	Professional	TC	$92.80	$109.18	$109.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.07 / $78.59 / $132.88	Professional		$43.07	$78.59	$132.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.25 / $46.25 / $46.25	Facility	26	$46.25	$46.25	$46.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.31 / $133.69 / $295.64	Professional		$88.31	$133.69	$295.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.20 / $49.66 / $115.38	Professional	26	$32.20	$49.66	$115.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.87 / $82.19 / $198.88	Professional	TC	$49.87	$82.19	$198.88
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $33.40 / $47.67 / $54.66	Facility	26	$33.40	$47.67	$54.66
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $95.54 / $125.16 / $266.35	Professional		$95.54	$125.16	$266.35
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.40 / $47.67 / $107.89	Professional	26	$33.40	$47.67	$107.89
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $62.13 / $77.48 / $115.95	Professional	TC	$62.13	$77.48	$115.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.56 / $79.45 / $123.28	Professional		$36.56	$79.45	$123.28
United Facility/Professional Professional Modifier Low / Median / High Price $94.52 / $119.75 / $176.56	Professional		$94.52	$119.75	$176.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.01 / $45.60 / $61.90	Professional	26	$36.01	$45.60	$61.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.51 / $73.40 / $106.05	Professional	TC	$58.51	$73.40	$106.05