Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $138.04 / $870.96	Professional		$64.57	$138.04	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $251.19 / $794.33	Professional	26	$22.91	$251.19	$794.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $75.86 / $234.42	Professional	TC	$38.90	$75.86	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Professional		$107.15	$107.15	$107.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $37.15 / $37.15	Professional	26	$37.15	$37.15	$37.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $177.83 / $177.83	Professional		$154.88	$177.83	$177.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	26	$44.67	$44.67	$44.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	TC	$97.72	$97.72	$97.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $91.20 / $165.96	Professional		$30.20	$91.20	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $77.62 / $436.52	Professional		$34.67	$77.62	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $28.84 / $109.65	Professional	26	$13.80	$28.84	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.02 / $181.97	Professional	TC	$20.89	$38.02	$181.97
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $104.71 / $346.74	Professional		$67.61	$104.71	$346.74
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $38.02 / $660.69	Professional	26	$24.55	$38.02	$660.69
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $70.79 / $147.91	Professional	TC	$40.74	$70.79	$147.91
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $151.36	Professional		$33.88	$47.86	$151.36
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.13 / $38.02	Professional	26	$12.02	$14.13	$38.02
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $35.48 / $117.49	Professional	TC	$19.95	$35.48	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $72.44 / $123.03	Professional		$45.71	$72.44	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $29.51 / $42.66	Professional	26	$18.20	$29.51	$42.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $43.65 / $83.18	Professional	TC	$27.54	$43.65	$83.18