Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.16 / $184.02 / $357.59	Professional		$92.16	$184.02	$357.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.79 / $29.15 / $135.44	Professional	26	$17.79	$29.15	$135.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.16 / $209.25 / $376.71	Professional	TC	$130.16	$209.25	$376.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.22 / $22.22 / $30.00	Professional	26	$22.22	$22.22	$30.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $232.88 / $304.85 / $346.22	Professional		$232.88	$304.85	$346.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.17 / $27.17 / $36.22	Professional	26	$27.17	$27.17	$36.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $205.72 / $205.72 / $205.72	Professional	TC	$205.72	$205.72	$205.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.60 / $173.52 / $383.03	Professional		$21.60	$173.52	$383.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $122.82 / $331.21	Professional		$75.86	$122.82	$331.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.26 / $29.63 / $50.42	Professional	26	$10.26	$29.63	$50.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.55 / $100.42 / $294.16	Professional	TC	$55.55	$100.42	$294.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $156.12 / $178.34 / $318.61	Professional		$156.12	$178.34	$318.61
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $25.46 / $49.49 / $69.58	Professional	26	$25.46	$49.49	$69.58
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $106.63 / $127.25 / $280.83	Professional	TC	$106.63	$127.25	$280.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.44 / $169.09 / $223.38	Professional		$34.44	$169.09	$223.38
United Facility/Professional Professional Modifier Low / Median / High Price $109.78 / $178.55 / $237.86	Professional		$109.78	$178.55	$237.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.59 / $42.33 / $93.48	Professional	26	$15.59	$42.33	$93.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.19 / $107.05 / $204.09	Professional	TC	$89.19	$107.05	$204.09