Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.95 / $50.47 / $92.32	Professional		$43.95	$50.47	$92.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.41 / $32.24 / $135.30	Professional	26	$26.41	$32.24	$135.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $21.35 / $37.99	Professional	TC	$17.14	$21.35	$37.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.16 / $32.42 / $33.47	Professional	26	$16.16	$32.42	$33.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $67.51 / $93.61	Professional		$32.86	$67.51	$93.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $54.86 / $54.86	Professional	26	$54.86	$54.86	$54.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.48 / $43.01 / $77.59	Professional		$19.48	$43.01	$77.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.00 / $49.83 / $119.34	Professional		$26.00	$49.83	$119.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.61 / $32.64 / $91.00	Professional	26	$15.61	$32.64	$91.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $8.94 / $15.46 / $32.01	Professional	TC	$8.94	$15.46	$32.01
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $49.52 / $52.99 / $93.07	Professional		$49.52	$52.99	$93.07
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $33.47 / $135.30	Professional	26	$30.50	$33.47	$135.30
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.23 / $19.14 / $36.19	Professional	TC	$18.23	$19.14	$36.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.04 / $39.78 / $73.30	Professional		$28.04	$39.78	$73.30
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $49.49 / $79.83	Professional		$33.11	$49.49	$79.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.01 / $29.97 / $52.54	Professional	26	$19.01	$29.97	$52.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.69 / $19.48 / $26.67	Professional	TC	$11.69	$19.48	$26.67