Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.50 / $127.57 / $153.09	Facility	26	$121.50	$127.57	$153.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.15 / $197.03 / $294.89	Professional		$170.15	$197.03	$294.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.29 / $111.32 / $240.08	Professional	26	$96.29	$111.32	$240.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.38 / $79.70 / $121.40	Professional	TC	$70.38	$79.70	$121.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.75 / $168.52 / $195.54	Professional		$155.75	$168.52	$195.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $94.22 / $101.31 / $146.12	Professional	26	$94.22	$101.31	$146.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.58 / $169.26 / $310.14	Professional		$104.58	$169.26	$310.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $139.88 / $164.57 / $164.57	Professional	26	$139.88	$164.57	$164.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.86 / $126.22 / $218.94	Professional		$71.86	$126.22	$218.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.33 / $283.83 / $749.58	Professional		$153.33	$283.83	$749.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.13 / $158.31 / $441.69	Professional	26	$90.13	$158.31	$441.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.87 / $116.59 / $307.89	Professional	TC	$63.87	$116.59	$307.89
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $98.12 / $121.50 / $153.09	Facility	26	$98.12	$121.50	$153.09
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $175.99 / $201.21 / $294.36	Professional		$175.99	$201.21	$294.36
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $98.12 / $121.50 / $181.62	Professional	26	$98.12	$121.50	$181.62
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $74.36 / $79.70 / $113.60	Professional	TC	$74.36	$79.70	$113.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.91 / $105.85 / $193.27	Professional		$60.91	$105.85	$193.27
United Facility/Professional Professional Modifier Low / Median / High Price $182.74 / $214.76 / $304.01	Professional		$182.74	$214.76	$304.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.30 / $122.28 / $177.11	Professional	26	$104.30	$122.28	$177.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.22 / $92.60 / $130.22	Professional	TC	$77.22	$92.60	$130.22