Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.46 / $47.46 / $49.83	Facility	26	$47.46	$47.46	$49.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.62 / $283.07 / $450.52	Professional		$229.62	$283.07	$450.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.75 / $47.46 / $120.28	Professional	26	$36.75	$47.46	$120.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.87 / $240.20 / $388.90	Professional	TC	$192.87	$240.20	$388.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $201.06 / $201.06 / $201.06	Professional		$201.06	$201.06	$201.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $51.18 / $78.76	Professional	26	$37.88	$51.18	$78.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.26 / $351.90 / $452.44	Professional		$59.26	$351.90	$452.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.38 / $63.38 / $63.38	Professional	26	$63.38	$63.38	$63.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.45 / $326.88 / $523.73	Professional		$56.45	$326.88	$523.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.91 / $399.44 / $565.71	Professional		$235.91	$399.44	$565.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.34 / $57.50 / $87.35	Professional	26	$29.34	$57.50	$87.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.78 / $370.43 / $486.57	Professional	TC	$184.78	$370.43	$486.57
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $32.82 / $47.46 / $49.83	Facility	26	$32.82	$47.46	$49.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $201.74 / $283.62 / $433.43	Professional		$201.74	$283.62	$433.43
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $32.82 / $47.24 / $108.33	Professional	26	$32.82	$47.24	$108.33
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $168.93 / $246.19 / $388.90	Professional	TC	$168.93	$246.19	$388.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.19 / $233.47 / $307.89	Professional		$34.19	$233.47	$307.89
United Facility/Professional Professional Modifier Low / Median / High Price $223.28 / $272.35 / $373.47	Professional		$223.28	$272.35	$373.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.09 / $45.40 / $61.72	Professional	26	$38.09	$45.40	$61.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.29 / $224.31 / $314.02	Professional	TC	$179.29	$224.31	$314.02