Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.82 / $49.82 / $52.32	Facility	26	$49.82	$49.82	$52.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $411.83 / $455.58 / $667.57	Professional		$411.83	$455.58	$667.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.71 / $49.83 / $133.16	Professional	26	$36.71	$49.83	$133.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $375.12 / $405.75 / $602.77	Professional	TC	$375.12	$405.75	$602.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $295.48 / $295.48 / $295.48	Professional		$295.48	$295.48	$295.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.76 / $53.70 / $80.66	Professional	26	$39.76	$53.70	$80.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.23 / $552.55 / $697.97	Professional		$69.23	$552.55	$697.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.58 / $66.58 / $66.58	Professional	26	$66.58	$66.58	$66.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.22 / $496.82 / $767.93	Professional		$59.22	$496.82	$767.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $332.69 / $478.37 / $1,114.08	Professional		$332.69	$478.37	$1,114.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.08 / $60.28 / $92.59	Professional	26	$33.08	$60.28	$92.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $285.04 / $428.70 / $1,018.86	Professional	TC	$285.04	$428.70	$1,018.86
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $33.61 / $49.82 / $52.32	Facility	26	$33.61	$49.82	$52.32
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $351.20 / $455.57 / $638.14	Professional		$351.20	$455.57	$638.14
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.61 / $49.82 / $132.88	Professional	26	$33.61	$49.82	$132.88
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $317.58 / $405.75 / $608.63	Professional	TC	$317.58	$405.75	$608.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.19 / $338.99 / $458.21	Professional		$34.19	$338.99	$458.21
United Facility/Professional Professional Modifier Low / Median / High Price $412.77 / $482.17 / $719.96	Professional		$412.77	$482.17	$719.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.49 / $47.69 / $73.64	Professional	26	$40.49	$47.69	$73.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $376.63 / $427.73 / $589.76	Professional	TC	$376.63	$427.73	$589.76