Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.17 / $132.77 / $180.02	Professional		$89.17	$132.77	$180.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.85 / $53.50 / $141.88	Professional	26	$32.85	$53.50	$141.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.32 / $85.57 / $264.76	Professional	TC	$56.32	$85.57	$264.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.82 / $52.82 / $52.82	Professional	26	$52.82	$52.82	$52.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.04 / $149.24 / $192.20	Professional		$84.04	$149.24	$192.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.94 / $49.94 / $66.58	Professional	26	$49.94	$49.94	$66.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.68 / $88.68 / $88.68	Professional	TC	$88.68	$88.68	$88.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $91.01 / $164.71	Professional		$39.61	$91.01	$164.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.71 / $140.68 / $351.97	Professional		$53.71	$140.68	$351.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.85 / $52.04 / $145.76	Professional	26	$18.85	$52.04	$145.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.86 / $86.81 / $124.20	Professional	TC	$34.86	$86.81	$124.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $121.96 / $146.88 / $204.62	Professional		$121.96	$146.88	$204.62
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.02 / $54.65 / $109.87	Professional	26	$46.02	$54.65	$109.87
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $75.94 / $92.22 / $131.00	Professional	TC	$75.94	$92.22	$131.00
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 $77.52 / $143.15 / $197.35	Professional		$77.52	$143.15	$197.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.94 / $55.25 / $70.02	Professional	26	$27.94	$55.25	$70.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.58 / $86.59 / $115.45	Professional	TC	$49.58	$86.59	$115.45