Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.22 / $52.45 / $66.08	Facility	26	$39.22	$52.45	$66.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.34 / $164.74 / $225.23	Professional		$145.34	$164.74	$225.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.22 / $52.45 / $145.91	Professional	26	$39.22	$52.45	$145.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.82 / $121.23 / $170.16	Professional	TC	$96.82	$121.23	$170.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.13 / $29.34 / $52.35	Professional	26	$20.13	$29.34	$52.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $220.45 / $278.14	Professional		$61.75	$220.45	$278.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.53 / $66.04 / $66.04	Professional	26	$49.53	$66.04	$66.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.97 / $158.97 / $158.97	Professional	TC	$158.97	$158.97	$158.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.01 / $141.16 / $258.02	Professional		$41.01	$141.16	$258.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $99.62 / $296.35	Professional		$74.90	$99.62	$296.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.75 / $30.48 / $126.45	Professional	26	$18.75	$30.48	$126.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.53 / $63.29 / $182.60	Professional	TC	$49.53	$63.29	$182.60
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $39.22 / $55.06 / $58.74	Facility	26	$39.22	$55.06	$58.74
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $160.37 / $168.50 / $272.62	Professional		$160.37	$168.50	$272.62
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $40.27 / $55.06 / $96.88	Professional	26	$40.27	$55.06	$96.88
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $105.32 / $121.23 / $202.58	Professional	TC	$105.32	$121.23	$202.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.43 / $138.23 / $183.95	Professional		$34.43	$138.23	$183.95
United Facility/Professional Professional Modifier Low / Median / High Price $97.16 / $156.34 / $239.28	Professional		$97.16	$156.34	$239.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $55.00 / $73.41	Professional	26	$27.50	$55.00	$73.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.91 / $100.89 / $179.70	Professional	TC	$60.91	$100.89	$179.70