Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $386.91 / $386.91 / $457.67	Facility	26	$386.91	$386.91	$457.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,012.82 / $1,230.83 / $1,754.39	Professional		$1,012.82	$1,230.83	$1,754.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $286.60 / $359.23 / $723.61	Professional	26	$286.60	$359.23	$723.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $728.19 / $871.60 / $1,249.01	Professional	TC	$728.19	$871.60	$1,249.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $301.35 / $301.35 / $391.76	Professional	26	$301.35	$301.35	$391.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $475.25 / $1,408.37 / $1,648.97	Professional		$475.25	$1,408.37	$1,648.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $456.97 / $456.97 / $456.97	Professional	26	$456.97	$456.97	$456.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $268.08 / $662.81 / $1,108.21	Professional		$268.08	$662.81	$1,108.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $923.70 / $1,469.77 / $2,178.94	Professional		$923.70	$1,469.77	$2,178.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $263.05 / $441.87 / $590.39	Professional	26	$263.05	$441.87	$590.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $660.65 / $1,061.00 / $1,577.27	Professional	TC	$660.65	$1,061.00	$1,577.27
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $336.21 / $386.91 / $487.50	Facility	26	$336.21	$386.91	$487.50
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,072.24 / $1,299.75 / $1,754.39	Professional		$1,072.24	$1,299.75	$1,754.39
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $286.89 / $386.91 / $815.46	Professional	26	$286.89	$386.91	$815.46
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $749.80 / $881.22 / $1,226.36	Professional	TC	$749.80	$881.22	$1,226.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $283.96 / $715.07 / $1,194.62	Professional		$283.96	$715.07	$1,194.62
United Facility/Professional Professional Modifier Low / Median / High Price $1,132.24 / $1,386.16 / $2,234.19	Professional		$1,132.24	$1,386.16	$2,234.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $336.57 / $423.43 / $563.83	Professional	26	$336.57	$423.43	$563.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $789.37 / $934.45 / $1,285.76	Professional	TC	$789.37	$934.45	$1,285.76