Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.39 / $60.73 / $104.50	Professional		$45.39	$60.73	$104.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.35 / $35.53 / $46.48	Professional	26	$26.35	$35.53	$46.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.04 / $24.38 / $31.67	Professional	TC	$19.04	$24.38	$31.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.44 / $61.77 / $61.77	Professional		$58.44	$61.77	$61.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.38 / $35.38 / $47.76	Professional	26	$35.38	$35.38	$47.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.73 / $90.36 / $118.90	Professional		$45.73	$90.36	$118.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.05 / $58.05 / $58.05	Professional	26	$58.05	$58.05	$58.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.31 / $43.78 / $75.86	Professional		$24.31	$43.78	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.74 / $57.14 / $121.06	Professional		$47.74	$57.14	$121.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.60 / $34.54 / $68.72	Professional	26	$27.60	$34.54	$68.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $23.95 / $52.33	Professional	TC	$19.14	$23.95	$52.33
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $52.97 / $70.39 / $91.68	Professional		$52.97	$70.39	$91.68
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $31.17 / $39.09 / $53.63	Professional	26	$31.17	$39.09	$53.63
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $21.92 / $26.39 / $35.64	Professional	TC	$21.92	$26.39	$35.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $45.87 / $80.21	Professional		$28.70	$45.87	$80.21
United Facility/Professional Professional Modifier Low / Median / High Price $54.91 / $64.59 / $85.43	Professional		$54.91	$64.59	$85.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.83 / $40.01 / $53.19	Professional	26	$32.83	$40.01	$53.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.41 / $25.98 / $34.13	Professional	TC	$20.41	$25.98	$34.13