Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $264.93 / $264.93 / $278.18	Facility	26	$264.93	$264.93	$278.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $481.18 / $546.58 / $807.73	Professional		$481.18	$546.58	$807.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $198.28 / $264.93 / $546.21	Professional	26	$198.28	$264.93	$546.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.63 / $306.66 / $449.00	Professional	TC	$281.63	$306.66	$449.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $444.32 / $444.32 / $473.37	Professional		$444.32	$444.32	$473.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $202.91 / $290.64 / $301.83	Professional	26	$202.91	$290.64	$301.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $319.80 / $465.29 / $955.19	Professional		$319.80	$465.29	$955.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $342.03 / $342.03 / $342.03	Professional	26	$342.03	$342.03	$342.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $414.69 / $414.69 / $414.69	Professional	TC	$414.69	$414.69	$414.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $298.39 / $378.02 / $729.96	Professional		$298.39	$378.02	$729.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $432.31 / $809.46 / $1,089.36	Professional		$432.31	$809.46	$1,089.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $191.05 / $338.49 / $502.35	Professional	26	$191.05	$338.49	$502.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $236.63 / $412.34 / $826.60	Professional	TC	$236.63	$412.34	$826.60
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $179.72 / $264.93 / $275.64	Facility	26	$179.72	$264.93	$275.64
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $394.36 / $546.58 / $721.48	Professional		$394.36	$546.58	$721.48
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $179.72 / $264.93 / $427.23	Professional	26	$179.72	$264.93	$427.23
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $214.65 / $281.64 / $387.53	Professional	TC	$214.65	$281.64	$387.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $186.48 / $267.42 / $504.45	Professional		$186.48	$267.42	$504.45
United Facility/Professional Professional Modifier Low / Median / High Price $480.01 / $641.04 / $1,190.35	Professional		$480.01	$641.04	$1,190.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $207.68 / $260.95 / $363.70	Professional	26	$207.68	$260.95	$363.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.99 / $397.80 / $738.33	Professional	TC	$253.99	$397.80	$738.33