Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.82 / $38.82 / $40.76	Facility	26	$38.82	$38.82	$40.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $75.56 / $313.70	Professional		$62.40	$75.56	$313.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.12 / $46.58 / $544.26	Professional	26	$28.12	$46.58	$544.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.34 / $38.57 / $59.42	Professional	TC	$35.34	$38.57	$59.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.65 / $65.70 / $72.28	Professional		$61.65	$65.70	$72.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $42.42 / $46.82	Professional	26	$26.53	$42.42	$46.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.83 / $95.57 / $111.89	Professional		$46.83	$95.57	$111.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.73 / $52.73 / $52.73	Professional	26	$52.73	$52.73	$52.73
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.86 / $54.86 / $54.86	Professional	TC	$54.86	$54.86	$54.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $51.18 / $101.24	Professional		$40.40	$51.18	$101.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.93 / $106.51 / $145.44	Professional		$58.93	$106.51	$145.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.65 / $43.05 / $72.81	Professional	26	$27.65	$43.05	$72.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.86 / $52.52 / $80.06	Professional	TC	$30.86	$52.52	$80.06
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $24.42 / $38.82 / $40.11	Facility	26	$24.42	$38.82	$40.11
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $53.47 / $75.56 / $128.47	Professional		$53.47	$75.56	$128.47
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.42 / $39.74 / $282.79	Professional	26	$24.42	$39.74	$282.79
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $29.05 / $36.74 / $56.67	Professional	TC	$29.05	$36.74	$56.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $40.55 / $73.98	Professional		$28.18	$40.55	$73.98
United Facility/Professional Professional Modifier Low / Median / High Price $63.96 / $77.14 / $105.31	Professional		$63.96	$77.14	$105.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.15 / $36.92 / $50.94	Professional	26	$28.15	$36.92	$50.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.97 / $41.57 / $59.63	Professional	TC	$32.97	$41.57	$59.63