Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.98 / $79.98 / $100.78	Facility	26	$79.98	$79.98	$100.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.24 / $109.04 / $173.87	Professional		$87.24	$109.04	$173.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.78 / $68.94 / $100.40	Professional	26	$56.78	$68.94	$100.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.48 / $45.71 / $62.56	Professional	TC	$28.48	$45.71	$62.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.29 / $101.38 / $101.38	Professional		$89.29	$101.38	$101.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.41 / $78.84 / $134.88	Professional	26	$58.41	$78.84	$134.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $110.80 / $178.68	Professional		$66.73	$110.80	$178.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.58 / $94.80 / $94.80	Professional	26	$80.58	$94.80	$94.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.37 / $71.37 / $71.37	Professional	TC	$71.37	$71.37	$71.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.98 / $66.80 / $121.60	Professional		$45.98	$66.80	$121.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.76 / $136.28 / $446.68	Professional		$102.76	$136.28	$446.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.62 / $91.16 / $251.97	Professional	26	$66.62	$91.16	$251.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.69 / $46.56 / $194.71	Professional	TC	$32.69	$46.56	$194.71
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $61.19 / $79.98 / $81.42	Facility	26	$61.19	$79.98	$81.42
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $87.97 / $113.94 / $178.85	Professional		$87.97	$113.94	$178.85
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.14 / $70.09 / $106.65	Professional	26	$58.14	$70.09	$106.65
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.76 / $45.74 / $69.61	Professional	TC	$26.76	$45.74	$69.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.54 / $45.42 / $119.03	Professional		$28.54	$45.42	$119.03
United Facility/Professional Professional Modifier Low / Median / High Price $88.63 / $109.04 / $145.63	Professional		$88.63	$109.04	$145.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.94 / $72.38 / $103.64	Professional	26	$60.94	$72.38	$103.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.20 / $34.63 / $54.68	Professional	TC	$27.20	$34.63	$54.68