Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.62 / $291.17 / $1,153.07	Professional		$189.62	$291.17	$1,153.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.84 / $65.18 / $178.30	Professional	26	$38.84	$65.18	$178.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $133.25 / $242.94 / $613.94	Professional	TC	$133.25	$242.94	$613.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.38 / $60.65 / $81.88	Professional	26	$44.38	$60.65	$81.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.13 / $608.11 / $656.14	Professional		$93.13	$608.11	$656.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.70 / $74.70 / $99.60	Professional	26	$74.70	$74.70	$99.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $389.87 / $389.87 / $389.87	Professional	TC	$389.87	$389.87	$389.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.17 / $343.19 / $723.37	Professional		$59.17	$343.19	$723.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.80 / $196.96 / $653.15	Professional		$120.80	$196.96	$653.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.19 / $60.82 / $147.22	Professional	26	$28.19	$60.82	$147.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.84 / $157.56 / $441.90	Professional	TC	$83.84	$157.56	$441.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $196.28 / $241.60 / $633.48	Professional		$196.28	$241.60	$633.48
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $48.75 / $61.17 / $126.75	Professional	26	$48.75	$61.17	$126.75
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $109.94 / $157.28 / $492.20	Professional	TC	$109.94	$157.28	$492.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.47 / $326.03 / $420.89	Professional		$34.47	$326.03	$420.89
United Facility/Professional Professional Modifier Low / Median / High Price $137.85 / $247.07 / $576.49	Professional		$137.85	$247.07	$576.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.50 / $65.48 / $94.49	Professional	26	$40.50	$65.48	$94.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.68 / $206.57 / $482.00	Professional	TC	$95.68	$206.57	$482.00