Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.84 / $70.84 / $118.75	Professional		$47.84	$70.84	$118.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.27 / $26.28 / $42.94	Professional	26	$19.27	$26.28	$42.94
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.70 / $29.19 / $37.54	Professional	52	$22.70	$29.19	$37.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.56 / $39.43 / $60.08	Professional	TC	$26.56	$39.43	$60.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.30 / $61.03 / $85.95	Professional		$57.30	$61.03	$85.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.71 / $34.71 / $34.71	Professional	26	$34.71	$34.71	$34.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.34 / $54.78 / $94.12	Facility		$39.34	$54.78	$94.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.34 / $75.30 / $117.65	Professional		$39.34	$75.30	$117.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.08 / $42.08 / $42.08	Professional	26	$42.08	$42.08	$42.08
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.59 / $58.59 / $58.59	Professional	TC	$58.59	$58.59	$58.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.57 / $39.19 / $74.37	Facility		$25.57	$39.19	$74.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.76 / $40.59 / $74.37	Professional		$24.76	$40.59	$74.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.04 / $58.65 / $119.78	Professional		$47.04	$58.65	$119.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.96 / $25.12 / $49.81	Professional	26	$19.96	$25.12	$49.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.78 / $33.79 / $65.72	Professional	TC	$26.78	$33.79	$65.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $51.47 / $74.39 / $103.75	Professional		$51.47	$74.39	$103.75
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $28.12 / $38.50	Professional	26	$18.76	$28.12	$38.50
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $23.92 / $35.43 / $35.43	Professional	52	$23.92	$35.43	$35.43
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $31.34 / $39.71 / $60.07	Professional	TC	$31.34	$39.71	$60.07
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 $57.47 / $71.47 / $98.08	Professional		$57.47	$71.47	$98.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.67 / $28.70 / $38.22	Professional	26	$23.67	$28.70	$38.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.94 / $39.69 / $56.78	Professional	TC	$31.94	$39.69	$56.78