Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $47.65	Facility	26	$37.82	$37.82	$47.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.48 / $154.59 / $283.08	Professional		$118.48	$154.59	$283.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.98 / $37.82 / $99.30	Professional	26	$29.98	$37.82	$99.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.75 / $116.76 / $241.80	Professional	TC	$86.75	$116.76	$241.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.32 / $136.32 / $160.80	Professional		$136.32	$136.32	$160.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.70 / $40.90 / $65.43	Professional	26	$24.70	$40.90	$65.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.72 / $293.31 / $351.97	Professional		$49.72	$293.31	$351.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.13 / $51.13 / $51.13	Professional	26	$51.13	$51.13	$51.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $262.57 / $262.57 / $262.57	Professional	TC	$262.57	$262.57	$262.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.50 / $176.84 / $239.38	Professional		$34.50	$176.84	$239.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $37.04 / $37.04	Facility	26	$37.04	$37.04	$37.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.07 / $174.36 / $419.97	Professional		$99.07	$174.36	$419.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.17 / $40.69 / $91.66	Professional	26	$26.17	$40.69	$91.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.42 / $131.66 / $386.48	Professional	TC	$68.42	$131.66	$386.48
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $27.26 / $37.82 / $47.65	Facility	26	$27.26	$37.82	$47.65
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $109.24 / $154.59 / $253.02	Professional		$109.24	$154.59	$253.02
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.26 / $37.82 / $66.16	Professional	26	$27.26	$37.82	$66.16
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $81.97 / $116.76 / $178.24	Professional	TC	$81.97	$116.76	$178.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.07 / $121.05 / $199.65	Professional		$36.07	$121.05	$199.65
United Facility/Professional Professional Modifier Low / Median / High Price $106.64 / $146.50 / $212.35	Professional		$106.64	$146.50	$212.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.13 / $37.08 / $51.44	Professional	26	$31.13	$37.08	$51.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.81 / $107.02 / $165.95	Professional	TC	$65.81	$107.02	$165.95