Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.65 / $44.65 / $46.89	Facility	26	$44.65	$44.65	$46.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.22 / $248.28 / $430.34	Professional		$171.22	$248.28	$430.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.35 / $44.66 / $83.55	Professional	26	$30.35	$44.66	$83.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.87 / $230.18 / $339.45	Professional	TC	$140.87	$230.18	$339.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.36 / $239.36 / $239.36	Professional		$239.36	$239.36	$239.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.69 / $48.28 / $53.36	Professional	26	$30.69	$48.28	$53.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.46 / $382.75 / $464.55	Professional		$53.46	$382.75	$464.55
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.18 / $60.18 / $60.18	Professional	26	$60.18	$60.18	$60.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $368.03 / $368.03 / $368.03	Professional	TC	$368.03	$368.03	$368.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.64 / $289.45 / $447.41	Professional		$52.64	$289.45	$447.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.56 / $315.44 / $571.98	Professional		$244.56	$315.44	$571.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.04 / $51.86 / $83.22	Professional	26	$31.04	$51.86	$83.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $180.69 / $278.51 / $488.76	Professional	TC	$180.69	$278.51	$488.76
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $27.32 / $44.65 / $45.71	Facility	26	$27.32	$44.65	$45.71
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $146.61 / $286.54 / $380.30	Professional		$146.61	$286.54	$380.30
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.32 / $44.65 / $77.39	Professional	26	$27.32	$44.65	$77.39
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $119.29 / $244.54 / $330.37	Professional	TC	$119.29	$244.54	$330.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.44 / $234.09 / $309.97	Professional		$34.44	$234.09	$309.97
United Facility/Professional Professional Modifier Low / Median / High Price $168.67 / $261.49 / $423.69	Professional		$168.67	$261.49	$423.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.22 / $42.48 / $58.86	Professional	26	$32.22	$42.48	$58.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.68 / $218.91 / $293.62	Professional	TC	$143.68	$218.91	$293.62