Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.81 / $105.24 / $132.94	Professional		$80.81	$105.24	$132.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.28 / $78.58 / $109.45	Professional	26	$63.28	$78.58	$109.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $28.89 / $35.85	Professional	TC	$17.73	$28.89	$35.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.68 / $101.68 / $101.68	Professional		$101.68	$101.68	$101.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.70 / $73.70 / $73.70	Professional	26	$73.70	$73.70	$73.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.33 / $152.60 / $195.46	Professional		$43.33	$152.60	$195.46
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.90 / $120.90 / $120.90	Professional	26	$120.90	$120.90	$120.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.81 / $91.51 / $126.06	Professional		$25.81	$91.51	$126.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.78 / $99.60 / $199.24	Professional		$77.78	$99.60	$199.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.08 / $72.43 / $143.75	Professional	26	$55.08	$72.43	$143.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.52 / $24.62 / $55.48	Professional	TC	$17.52	$24.62	$55.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $94.37 / $114.03 / $143.41	Professional		$94.37	$114.03	$143.41
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $72.87 / $84.60 / $109.09	Professional	26	$72.87	$84.60	$109.09
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.69 / $29.62 / $35.85	Professional	TC	$19.69	$29.62	$35.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.66 / $102.27 / $160.04	Professional		$30.66	$102.27	$160.04
United Facility/Professional Professional Modifier Low / Median / High Price $91.38 / $110.34 / $142.30	Professional		$91.38	$110.34	$142.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.33 / $83.78 / $110.74	Professional	26	$69.33	$83.78	$110.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.94 / $23.64 / $35.19	Professional	TC	$17.94	$23.64	$35.19