Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $575.44	Professional		$112.20	$194.98	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $95.50 / $457.09	Professional	26	$30.20	$95.50	$457.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $112.20 / $295.12	Professional	TC	$75.86	$112.20	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $35.48 / $46.77	Professional	26	$18.20	$35.48	$46.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $275.42	Professional		$199.53	$257.04	$275.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $60.26 / $60.26	Professional	26	$60.26	$60.26	$60.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	TC	$162.18	$162.18	$162.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $154.88 / $416.87	Facility		$35.48	$154.88	$416.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $147.91 / $269.15	Professional		$39.81	$147.91	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $102.33 / $676.08	Professional		$54.95	$102.33	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $40.74 / $144.54	Professional	26	$19.50	$40.74	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $66.07 / $288.40	Professional	TC	$43.65	$66.07	$288.40
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $173.78 / $426.58	Professional		$107.15	$173.78	$426.58
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $46.77 / $288.40	Professional	26	$30.20	$46.77	$288.40
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $117.49 / $288.40	Professional	TC	$61.66	$117.49	$288.40
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $81.28 / $234.42	Professional		$54.95	$81.28	$234.42
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $19.50 / $50.12	Professional	26	$16.22	$19.50	$50.12
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $61.66 / $181.97	Professional	TC	$35.48	$61.66	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $117.49 / $229.09	Professional		$74.13	$117.49	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $39.81 / $56.23	Professional	26	$23.99	$39.81	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $81.28 / $177.83	Professional	TC	$48.98	$81.28	$177.83