Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.58 / $179.10 / $605.20	Professional		$67.58	$179.10	$605.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.69 / $34.82 / $427.68	Professional	26	$24.69	$34.82	$427.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.25 / $77.18 / $155.27	Professional	TC	$39.25	$77.18	$155.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.37 / $106.37 / $106.37	Professional		$106.37	$106.37	$106.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.87 / $35.56 / $35.56	Professional	26	$19.87	$35.56	$35.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.92 / $132.22 / $183.34	Professional		$43.92	$132.22	$183.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.56 / $33.56 / $44.74	Professional	26	$33.56	$33.56	$44.74
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $98.66 / $98.66 / $98.66	Professional	TC	$98.66	$98.66	$98.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.49 / $86.91 / $183.19	Professional		$26.49	$86.91	$183.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $64.09 / $211.93	Professional		$34.72	$64.09	$211.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.72 / $26.35 / $68.22	Professional	26	$12.72	$26.35	$68.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.97 / $38.79 / $143.72	Professional	TC	$20.97	$38.79	$143.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $67.91 / $103.87 / $272.36	Professional		$67.91	$103.87	$272.36
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.03 / $31.27 / $427.68	Professional	26	$27.03	$31.27	$427.68
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $40.88 / $53.60 / $130.00	Professional	TC	$40.88	$53.60	$130.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.47 / $75.37 / $146.84	Professional		$34.47	$75.37	$146.84
United Facility/Professional Professional Modifier Low / Median / High Price $46.62 / $72.48 / $131.87	Professional		$46.62	$72.48	$131.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $29.45 / $42.45	Professional	26	$18.14	$29.45	$42.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.07 / $43.27 / $83.45	Professional	TC	$28.07	$43.27	$83.45