Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $491.39 / $491.40 / $619.16	Facility	26	$491.39	$491.40	$619.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,195.30 / $1,472.74 / $2,078.50	Professional		$1,195.30	$1,472.74	$2,078.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $363.17 / $456.36 / $667.69	Professional	26	$363.17	$456.36	$667.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $383.59 / $383.59 / $383.59	Professional	26	$383.59	$383.59	$383.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,166.14 / $1,365.37 / $1,859.36	Professional		$1,166.14	$1,365.37	$1,859.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $581.07 / $581.07 / $581.07	Professional	26	$581.07	$581.07	$581.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $340.57 / $771.16 / $1,323.49	Professional		$340.57	$771.16	$1,323.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,103.07 / $1,753.67 / $2,604.00	Professional		$1,103.07	$1,753.67	$2,604.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $333.38 / $553.15 / $749.53	Professional	26	$333.38	$553.15	$749.53
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $420.67 / $491.39 / $619.16	Facility	26	$420.67	$491.39	$619.16
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,260.18 / $1,506.28 / $2,078.50	Professional		$1,260.18	$1,506.28	$2,078.50
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $368.25 / $491.39 / $856.34	Professional	26	$368.25	$491.39	$856.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $315.80 / $849.05 / $1,394.98	Professional		$315.80	$849.05	$1,394.98
United Facility/Professional Professional Modifier Low / Median / High Price $1,365.19 / $1,631.90 / $2,171.91	Professional		$1,365.19	$1,631.90	$2,171.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $416.50 / $543.26 / $714.64	Professional	26	$416.50	$543.26	$714.64