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 $328.32 / $424.11 / $716.15	Professional		$328.32	$424.11	$716.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $60.69 / $145.26	Professional	26	$51.32	$60.69	$145.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.79 / $390.00 / $565.73	Professional	TC	$281.79	$390.00	$565.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $412.62 / $434.25 / $564.53	Professional		$412.62	$434.25	$564.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.67 / $54.48 / $88.37	Professional	26	$50.67	$54.48	$88.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.66 / $657.49 / $808.52	Professional		$82.66	$657.49	$808.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.15 / $88.41 / $88.41	Professional	26	$75.15	$88.41	$88.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.42 / $423.96 / $547.39	Professional		$59.42	$423.96	$547.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.39 / $678.55 / $1,982.58	Professional		$298.39	$678.55	$1,982.58
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 $253.38 / $594.75 / $1,746.63	Professional	TC	$253.38	$594.75	$1,746.63
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $53.02 / $65.29 / $82.27	Facility	26	$53.02	$65.29	$82.27
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $338.67 / $496.04 / $639.32	Professional		$338.67	$496.04	$639.32
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.49 / $65.29 / $129.02	Professional	26	$51.49	$65.29	$129.02
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $287.33 / $430.74 / $556.29	Professional	TC	$287.33	$430.74	$556.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.87 / $369.52 / $566.10	Professional		$61.87	$369.52	$566.10
United Facility/Professional Professional Modifier Low / Median / High Price $221.09 / $435.58 / $645.08	Professional		$221.09	$435.58	$645.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.41 / $64.98 / $89.35	Professional	26	$53.41	$64.98	$89.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $174.34 / $370.75 / $549.84	Professional	TC	$174.34	$370.75	$549.84