Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.56 / $149.24 / $349.26	Professional		$112.56	$149.24	$349.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.59 / $37.06 / $69.62	Professional	26	$34.59	$37.06	$69.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $114.43 / $296.42	Professional	TC	$68.95	$114.43	$296.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.60 / $26.45 / $47.29	Professional	26	$17.60	$26.45	$47.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.77 / $224.33 / $286.36	Professional		$55.77	$224.33	$286.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.65 / $59.65 / $59.65	Professional	26	$59.65	$59.65	$59.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $161.78 / $161.78 / $215.70	Professional	TC	$161.78	$161.78	$215.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.31 / $154.63 / $258.83	Facility		$42.31	$154.63	$258.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.26 / $142.35 / $300.04	Professional		$35.26	$142.35	$300.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $103.29 / $276.19	Professional		$66.06	$103.29	$276.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.96 / $36.90 / $90.11	Professional	26	$16.96	$36.90	$90.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.43 / $66.39 / $182.70	Professional	TC	$43.43	$66.39	$182.70
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $107.43 / $161.81 / $281.83	Professional		$107.43	$161.81	$281.83
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.86 / $41.61 / $102.22	Professional	26	$29.86	$41.61	$102.22
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $57.00 / $114.43 / $201.87	Professional	TC	$57.00	$114.43	$201.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.47 / $138.18 / $185.31	Professional		$34.47	$138.18	$185.31
United Facility/Professional Professional Modifier Low / Median / High Price $75.55 / $117.40 / $230.59	Professional		$75.55	$117.40	$230.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.69 / $39.90 / $56.08	Professional	26	$23.69	$39.90	$56.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.57 / $81.20 / $175.94	Professional	TC	$48.57	$81.20	$175.94