Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.26 / $91.65 / $153.16	Professional		$82.26	$91.65	$153.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.10 / $61.07 / $150.10	Professional	26	$51.10	$61.07	$150.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.21 / $36.35 / $58.83	Professional	TC	$28.21	$36.35	$58.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.06 / $42.21 / $58.22	Professional	26	$28.06	$42.21	$58.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.81 / $109.05 / $151.22	Professional		$46.81	$109.05	$151.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.34 / $95.34 / $95.34	Professional	26	$95.34	$95.34	$95.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.74 / $70.06 / $134.99	Professional		$27.74	$70.06	$134.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.92 / $86.39 / $150.90	Professional		$41.92	$86.39	$150.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.14 / $57.64 / $146.97	Professional	26	$27.14	$57.64	$146.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.43 / $25.05 / $52.84	Professional	TC	$13.43	$25.05	$52.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $88.44 / $100.82 / $168.73	Professional		$88.44	$100.82	$168.73
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.22 / $67.06 / $150.10	Professional	26	$58.22	$67.06	$150.10
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $31.91 / $36.35 / $51.51	Professional	TC	$31.91	$36.35	$51.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $65.66 / $107.26	Professional		$29.53	$65.66	$107.26
United Facility/Professional Professional Modifier Low / Median / High Price $55.22 / $92.03 / $128.84	Professional		$55.22	$92.03	$128.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.78 / $58.14 / $91.45	Professional	26	$37.78	$58.14	$91.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.03 / $28.29 / $44.17	Professional	TC	$16.03	$28.29	$44.17