Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.92 / $42.92 / $54.09	Facility	26	$42.92	$42.92	$54.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.65 / $96.34 / $245.72	Professional		$79.65	$96.34	$245.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.34 / $42.93 / $125.61	Professional	26	$33.34	$42.93	$125.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.53 / $55.88 / $92.06	Professional	TC	$42.53	$55.88	$92.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.31 / $78.29 / $140.91	Professional		$61.31	$78.29	$140.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.27 / $34.21 / $63.61	Professional	26	$28.27	$34.21	$63.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.64 / $44.08 / $44.08	Professional	TC	$40.64	$44.08	$44.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.78 / $82.53 / $142.36	Professional		$53.78	$82.53	$142.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.89 / $57.52 / $57.52	Professional	26	$48.89	$57.52	$57.52
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.45 / $79.36 / $79.36	Professional	TC	$67.45	$79.36	$79.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.78 / $57.19 / $101.78	Professional		$38.78	$57.19	$101.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.63 / $112.05 / $228.08	Professional		$70.63	$112.05	$228.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.84 / $45.48 / $104.21	Professional	26	$29.84	$45.48	$104.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.18 / $65.93 / $137.27	Professional	TC	$41.18	$65.93	$137.27
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $30.23 / $42.92 / $49.70	Facility	26	$30.23	$42.92	$49.70
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $73.04 / $96.34 / $168.16	Professional		$73.04	$96.34	$168.16
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.23 / $42.92 / $103.32	Professional	26	$30.23	$42.92	$103.32
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $42.81 / $53.41 / $81.59	Professional	TC	$42.81	$53.41	$81.59
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 $80.88 / $97.32 / $127.98	Professional		$80.88	$97.32	$127.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.44 / $40.59 / $57.14	Professional	26	$33.44	$40.59	$57.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.17 / $54.67 / $79.03	Professional	TC	$44.17	$54.67	$79.03