Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.59 / $80.61 / $101.56	Facility	26	$80.59	$80.61	$101.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.53 / $280.54 / $688.26	Professional		$215.53	$280.54	$688.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.47 / $80.61 / $264.00	Professional	26	$62.47	$80.61	$264.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.75 / $192.25 / $288.13	Professional	TC	$152.75	$192.25	$288.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $176.88 / $176.88 / $176.88	Professional		$176.88	$176.88	$176.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.07 / $59.07 / $59.07	Professional	26	$59.07	$59.07	$59.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.64 / $305.14 / $385.44	Professional		$89.64	$305.14	$385.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.48 / $95.87 / $95.87	Professional	26	$81.48	$95.87	$95.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.72 / $178.28 / $262.77	Professional		$64.72	$178.28	$262.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.50 / $69.50 / $69.50	Facility	26	$69.50	$69.50	$69.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.63 / $288.32 / $689.02	Professional		$219.63	$288.32	$689.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.98 / $85.41 / $176.18	Professional	26	$62.98	$85.41	$176.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.58 / $206.45 / $503.01	Professional	TC	$162.58	$206.45	$503.01
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $62.83 / $80.59 / $101.56	Facility	26	$62.83	$80.59	$101.56
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $201.21 / $280.54 / $659.60	Professional		$201.21	$280.54	$659.60
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $62.52 / $80.59 / $226.90	Professional	26	$62.52	$80.59	$226.90
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $138.38 / $179.09 / $253.33	Professional	TC	$138.38	$179.09	$253.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.56 / $176.23 / $262.80	Professional		$36.56	$176.23	$262.80
United Facility/Professional Professional Modifier Low / Median / High Price $220.85 / $263.27 / $350.45	Professional		$220.85	$263.27	$350.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.91 / $78.29 / $109.27	Professional	26	$63.91	$78.29	$109.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.93 / $189.37 / $265.94	Professional	TC	$154.93	$189.37	$265.94