Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.52 / $22.52 / $28.37	Facility	26	$22.52	$22.52	$28.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.50 / $79.25 / $130.46	Professional		$56.50	$79.25	$130.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $22.09 / $49.33	Professional	26	$17.98	$22.09	$49.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $70.61 / $91.79	Professional		$70.61	$70.61	$91.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.14 / $25.14 / $26.93	Professional	26	$25.14	$25.14	$26.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.39 / $104.07 / $125.98	Professional		$28.39	$104.07	$125.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.36 / $30.36 / $30.36	Professional	26	$30.36	$30.36	$30.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22.24 / $62.44 / $92.30	Professional		$22.24	$62.44	$92.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.76 / $76.50 / $134.28	Professional		$39.76	$76.50	$134.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.53 / $22.14 / $32.04	Professional	26	$14.53	$22.14	$32.04
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $18.57 / $18.57 / $28.37	Facility	26	$18.57	$18.57	$28.37
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $61.37 / $79.78 / $124.48	Professional		$61.37	$79.78	$124.48
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $18.53 / $22.51 / $49.33	Professional	26	$18.53	$22.51	$49.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.89 / $67.53 / $96.63	Professional		$53.89	$67.53	$96.63
United Facility/Professional Professional Modifier Low / Median / High Price $42.48 / $77.26 / $111.40	Professional		$42.48	$77.26	$111.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.19 / $22.23 / $32.15	Professional	26	$18.19	$22.23	$32.15