Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.40 / $135.08 / $230.00	Professional		$89.40	$135.08	$230.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.02 / $37.99 / $54.55	Professional	26	$27.02	$37.99	$54.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.27 / $84.00 / $190.10	Professional	TC	$54.27	$84.00	$190.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.22 / $139.22 / $139.22	Professional		$139.22	$139.22	$139.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.91 / $24.61 / $43.95	Professional	26	$16.91	$24.61	$43.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.79 / $204.85 / $239.84	Professional		$51.79	$204.85	$239.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.54 / $41.54 / $55.39	Professional	26	$41.54	$41.54	$55.39
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.41 / $131.41 / $131.41	Professional	TC	$131.41	$131.41	$131.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.82 / $115.94 / $244.37	Professional		$32.82	$115.94	$244.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.80 / $95.64 / $250.04	Professional		$55.80	$95.64	$250.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.73 / $39.97 / $116.82	Professional	26	$15.73	$39.97	$116.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.25 / $56.49 / $154.71	Professional	TC	$29.25	$56.49	$154.71
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $99.98 / $134.18 / $236.67	Professional		$99.98	$134.18	$236.67
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $35.97 / $42.66 / $71.37	Professional	26	$35.97	$42.66	$71.37
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $60.15 / $79.95 / $172.49	Professional	TC	$60.15	$79.95	$172.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.47 / $113.06 / $183.95	Professional		$34.47	$113.06	$183.95
United Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $93.41 / $167.02	Professional		$62.30	$93.41	$167.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.52 / $37.68 / $53.64	Professional	26	$22.52	$37.68	$53.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.70 / $57.50 / $108.23	Professional	TC	$35.70	$57.50	$108.23