Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.84 / $119.84 / $125.83	Facility	26	$119.84	$119.84	$125.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.85 / $177.64 / $269.12	Professional		$135.85	$177.64	$269.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $195.48 / $195.48 / $195.48	Professional		$195.48	$195.48	$195.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.45 / $140.13 / $262.16	Professional		$39.45	$140.13	$262.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.20 / $100.79 / $191.33	Professional		$77.20	$100.79	$191.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.31 / $221.96 / $705.81	Professional		$164.31	$221.96	$705.81
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $92.37 / $119.84 / $121.99	Facility	26	$92.37	$119.84	$121.99
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $153.84 / $186.96 / $274.11	Professional		$153.84	$186.96	$274.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.01 / $104.78 / $191.03	Professional		$60.01	$104.78	$191.03
United Facility/Professional Professional Modifier Low / Median / High Price $151.19 / $186.76 / $264.61	Professional		$151.19	$186.76	$264.61