Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.72 / $32.72 / $41.23	Facility	26	$32.72	$32.72	$41.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.12 / $124.99 / $333.61	Professional		$99.12	$124.99	$333.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.47 / $32.72 / $112.00	Professional	26	$23.47	$32.72	$112.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.04 / $92.26 / $137.19	Professional	TC	$74.04	$92.26	$137.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.48 / $75.48 / $122.68	Professional		$75.48	$75.48	$122.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $30.06 / $36.08	Professional	26	$19.23	$30.06	$36.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.17 / $130.87 / $167.22	Professional		$38.17	$130.87	$167.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.04 / $38.88 / $38.88	Professional	26	$33.04	$38.88	$38.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.14 / $116.64 / $116.64	Professional	TC	$99.14	$116.64	$116.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.25 / $83.99 / $118.61	Professional		$26.25	$83.99	$118.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.20 / $28.20 / $28.20	Facility	26	$28.20	$28.20	$28.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.06 / $132.97 / $290.29	Professional		$100.06	$132.97	$290.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.40 / $34.67 / $71.70	Professional	26	$25.40	$34.67	$71.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.37 / $101.84 / $234.74	Professional	TC	$76.37	$101.84	$234.74
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $25.11 / $32.72 / $37.10	Facility	26	$25.11	$32.72	$37.10
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $98.35 / $124.98 / $325.47	Professional		$98.35	$124.98	$325.47
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.10 / $32.72 / $107.91	Professional	26	$24.10	$32.72	$107.91
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $73.23 / $92.26 / $131.49	Professional	TC	$73.23	$92.26	$131.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $78.92 / $122.43	Professional		$36.43	$78.92	$122.43
United Facility/Professional Professional Modifier Low / Median / High Price $100.69 / $127.85 / $168.76	Professional		$100.69	$127.85	$168.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.64 / $31.86 / $42.69	Professional	26	$25.64	$31.86	$42.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.34 / $100.07 / $129.46	Professional	TC	$74.34	$100.07	$129.46