Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.07 / $39.07 / $49.22	Facility	26	$39.07	$39.07	$49.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.54 / $125.82 / $349.80	Professional		$85.54	$125.82	$349.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $39.07 / $122.20	Professional	26	$29.75	$39.07	$122.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.59 / $94.28 / $177.83	Professional	TC	$69.59	$94.28	$177.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.15 / $94.94 / $104.51	Professional		$74.15	$94.94	$104.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.20 / $41.64 / $63.68	Professional	26	$24.20	$41.64	$63.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.89 / $129.01 / $187.64	Professional		$45.89	$129.01	$187.64
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.66 / $51.66 / $51.66	Professional	26	$51.66	$51.66	$51.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.57 / $115.57 / $115.57	Professional	TC	$115.57	$115.57	$115.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $83.23 / $127.86	Professional		$34.79	$83.23	$127.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.09 / $132.65 / $285.45	Professional		$89.09	$132.65	$285.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.09 / $39.60 / $92.91	Professional	26	$26.09	$39.60	$92.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.99 / $87.84 / $209.31	Professional	TC	$59.99	$87.84	$209.31
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $26.53 / $39.07 / $43.83	Facility	26	$26.53	$39.07	$43.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $100.04 / $120.64 / $236.90	Professional		$100.04	$120.64	$236.90
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $39.07 / $96.74	Professional	26	$26.53	$39.07	$96.74
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $73.51 / $83.48 / $158.40	Professional	TC	$73.51	$83.48	$158.40
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 $101.15 / $120.67 / $174.74	Professional		$101.15	$120.67	$174.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.05 / $38.07 / $73.00	Professional	26	$30.05	$38.07	$73.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.61 / $84.19 / $117.69	Professional	TC	$65.61	$84.19	$117.69