Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.40 / $95.98 / $115.17	Facility	26	$91.40	$95.98	$115.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.78 / $153.71 / $261.35	Professional		$133.78	$153.71	$261.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $82.87 / $147.00	Professional	26	$72.04	$82.87	$147.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.95 / $62.30 / $94.39	Professional	TC	$53.95	$62.30	$94.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.14 / $128.86 / $167.52	Professional		$119.14	$128.86	$167.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.68 / $98.80 / $131.60	Professional	26	$70.68	$98.80	$131.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.40 / $128.50 / $237.24	Professional		$91.40	$128.50	$237.24
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.56 / $123.56 / $123.56	Professional	26	$123.56	$123.56	$123.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.43 / $94.74 / $167.28	Professional		$56.43	$94.74	$167.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.33 / $217.37 / $574.05	Professional		$117.33	$217.37	$574.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.65 / $118.73 / $332.35	Professional	26	$67.65	$118.73	$332.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.69 / $91.53 / $241.71	Professional	TC	$49.69	$91.53	$241.71
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $76.91 / $91.40 / $115.17	Facility	26	$76.91	$91.40	$115.17
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $133.79 / $153.71 / $239.62	Professional		$133.79	$153.71	$239.62
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $73.89 / $91.40 / $137.11	Professional	26	$73.89	$91.40	$137.11
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $58.45 / $62.29 / $87.28	Professional	TC	$58.45	$62.29	$87.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.28 / $104.25 / $162.37	Professional		$60.28	$104.25	$162.37
United Facility/Professional Professional Modifier Low / Median / High Price $141.08 / $163.56 / $233.52	Professional		$141.08	$163.56	$233.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.48 / $91.31 / $132.53	Professional	26	$77.48	$91.31	$132.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.55 / $70.95 / $105.18	Professional	TC	$60.55	$70.95	$105.18