Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.18 / $390.59 / $721.25	Professional		$300.18	$390.59	$721.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.21 / $141.15 / $568.10	Professional	26	$108.21	$141.15	$568.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.94 / $259.18 / $500.72	Professional	TC	$181.94	$259.18	$500.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.84 / $199.84 / $199.84	Professional		$199.84	$199.84	$199.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.90 / $98.55 / $176.54	Professional	26	$67.90	$98.55	$176.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.57 / $582.19 / $684.17	Professional		$218.57	$582.19	$684.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $166.97 / $166.97 / $222.63	Professional	26	$166.97	$166.97	$222.63
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $345.92 / $345.92 / $345.92	Professional	TC	$345.92	$345.92	$345.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $131.38 / $314.85 / $642.59	Professional		$131.38	$314.85	$642.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.38 / $330.23 / $579.37	Professional		$199.38	$330.23	$579.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.36 / $133.85 / $310.01	Professional	26	$63.36	$133.85	$310.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.90 / $176.76 / $391.48	Professional	TC	$123.90	$176.76	$391.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $344.41 / $445.42 / $702.01	Professional		$344.41	$445.42	$702.01
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $131.40 / $171.17 / $369.60	Professional	26	$131.40	$171.17	$369.60
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $277.14 / $436.56	Professional	TC	$208.93	$277.14	$436.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $124.00 / $290.76 / $463.59	Professional		$124.00	$290.76	$463.59
United Facility/Professional Professional Modifier Low / Median / High Price $202.84 / $333.34 / $598.72	Professional		$202.84	$333.34	$598.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.23 / $135.91 / $290.05	Professional	26	$80.23	$135.91	$290.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.27 / $180.08 / $385.00	Professional	TC	$114.27	$180.08	$385.00