Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.88 / $43.88 / $46.07	Facility	26	$43.88	$43.88	$46.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.87 / $337.61 / $506.41	Professional		$251.87	$337.61	$506.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.17 / $43.88 / $109.89	Professional	26	$33.17	$43.88	$109.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.71 / $299.66 / $449.49	Professional	TC	$218.71	$299.66	$449.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.03 / $49.22 / $73.69	Professional	26	$35.03	$49.22	$73.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.78 / $406.80 / $523.03	Professional		$54.78	$406.80	$523.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.59 / $58.59 / $58.59	Professional	26	$58.59	$58.59	$58.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.22 / $377.90 / $585.41	Professional		$52.22	$377.90	$585.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.94 / $455.82 / $652.62	Professional		$270.94	$455.82	$652.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.33 / $49.33 / $81.30	Professional	26	$26.33	$49.33	$81.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $219.81 / $440.79 / $656.95	Professional	TC	$219.81	$440.79	$656.95
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $30.70 / $43.88 / $46.07	Facility	26	$30.70	$43.88	$46.07
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $230.85 / $316.89 / $485.82	Professional		$230.85	$316.89	$485.82
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.70 / $43.88 / $105.62	Professional	26	$30.70	$43.88	$105.62
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $200.15 / $292.83 / $449.49	Professional	TC	$200.15	$292.83	$449.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.19 / $264.20 / $347.20	Professional		$34.19	$264.20	$347.20
United Facility/Professional Professional Modifier Low / Median / High Price $241.47 / $318.39 / $428.71	Professional		$241.47	$318.39	$428.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.77 / $41.58 / $57.58	Professional	26	$35.77	$41.58	$57.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.94 / $278.20 / $395.03	Professional	TC	$208.94	$278.20	$395.03