Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.79 / $214.94 / $651.49	Facility		$46.79	$214.94	$651.49
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.03 / $36.03 / $45.39	Facility	26	$36.03	$36.03	$45.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.02 / $125.90 / $287.79	Professional		$56.02	$125.90	$287.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.22 / $36.03 / $120.83	Professional	26	$27.22	$36.03	$120.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.82 / $41.58 / $187.42	Professional	TC	$25.82	$41.58	$187.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.03 / $57.77 / $72.20	Professional		$43.03	$57.77	$72.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.31 / $29.78 / $40.20	Professional	26	$25.31	$29.78	$40.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.54 / $69.03 / $119.97	Facility		$48.54	$69.03	$119.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.33 / $70.51 / $105.77	Professional		$43.33	$70.51	$105.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $47.93 / $47.93	Professional	26	$40.74	$47.93	$47.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.34 / $46.34 / $46.34	Professional	TC	$46.34	$46.34	$46.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.07 / $38.14 / $75.47	Facility		$28.07	$38.14	$75.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.11 / $37.31 / $70.76	Professional		$28.11	$37.31	$70.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.84 / $65.84 / $65.84	Facility		$65.84	$65.84	$65.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.51 / $34.51 / $34.51	Facility	26	$34.51	$34.51	$34.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.82 / $95.22 / $262.48	Professional		$48.82	$95.22	$262.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.73 / $38.57 / $88.47	Professional	26	$24.73	$38.57	$88.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.63 / $40.88 / $150.55	Professional	TC	$22.63	$40.88	$150.55
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $67.20 / $249.12 / $722.45	Facility		$67.20	$249.12	$722.45
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $26.47 / $36.03 / $45.39	Facility	26	$26.47	$36.03	$45.39
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $64.03 / $93.52 / $221.30	Professional		$64.03	$93.52	$221.30
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.47 / $36.03 / $85.62	Professional	26	$26.47	$36.03	$85.62
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.86 / $40.07 / $170.38	Professional	TC	$30.86	$40.07	$170.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $46.52 / $80.86	Professional		$28.59	$46.52	$80.86
United Facility/Professional Professional Modifier Low / Median / High Price $57.98 / $84.50 / $212.68	Professional		$57.98	$84.50	$212.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.18 / $35.67 / $49.44	Professional	26	$29.18	$35.67	$49.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.11 / $43.08 / $159.63	Professional	TC	$25.11	$43.08	$159.63