Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.29 / $65.29 / $82.27	Facility	26	$65.29	$65.29	$82.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.02 / $383.49 / $590.49	Professional		$286.02	$383.49	$590.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.33 / $59.88 / $141.69	Professional	26	$51.33	$59.88	$141.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.26 / $316.08 / $458.49	Professional	TC	$239.26	$316.08	$458.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.20 / $373.09 / $389.13	Professional		$346.20	$373.09	$389.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.67 / $54.48 / $98.06	Professional	26	$50.67	$54.48	$98.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.79 / $549.72 / $669.59	Professional		$86.79	$549.72	$669.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.15 / $88.41 / $88.41	Professional	26	$75.15	$88.41	$88.41
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $530.47 / $530.47 / $530.47	Professional	TC	$530.47	$530.47	$530.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.42 / $355.78 / $470.97	Professional		$59.42	$355.78	$470.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.58 / $591.29 / $1,700.59	Professional		$257.58	$591.29	$1,700.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.42 / $85.16 / $235.95	Professional	26	$48.42	$85.16	$235.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $503.14 / $1,464.64	Professional	TC	$218.78	$503.14	$1,464.64
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $53.60 / $65.29 / $82.27	Facility	26	$53.60	$65.29	$82.27
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $310.45 / $428.25 / $569.16	Professional		$310.45	$428.25	$569.16
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.70 / $65.29 / $112.14	Professional	26	$51.70	$65.29	$112.14
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $251.27 / $362.93 / $457.30	Professional	TC	$251.27	$362.93	$457.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.81 / $308.95 / $474.36	Professional		$61.81	$308.95	$474.36
United Facility/Professional Professional Modifier Low / Median / High Price $212.42 / $371.72 / $561.69	Professional		$212.42	$371.72	$561.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.27 / $65.02 / $89.99	Professional	26	$53.27	$65.02	$89.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.54 / $312.52 / $467.00	Professional	TC	$171.54	$312.52	$467.00