Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $215.34 / $215.35 / $271.33	Facility	26	$215.34	$215.35	$271.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.72 / $316.85 / $469.19	Professional		$278.72	$316.85	$469.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $171.18 / $196.59 / $295.38	Professional	26	$171.18	$196.59	$295.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.00 / $116.85 / $165.88	Professional	TC	$99.00	$116.85	$165.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $261.27 / $277.08 / $441.76	Professional		$261.27	$277.08	$441.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $160.26 / $189.55 / $346.00	Professional	26	$160.26	$189.55	$346.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $156.41 / $368.40 / $507.94	Professional		$156.41	$368.40	$507.94
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $291.86 / $291.86 / $291.86	Professional	26	$291.86	$291.86	$291.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $103.25 / $212.86 / $360.24	Professional		$103.25	$212.86	$360.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.91 / $443.47 / $1,222.93	Professional		$250.91	$443.47	$1,222.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $159.97 / $282.01 / $779.80	Professional	26	$159.97	$282.01	$779.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.23 / $167.80 / $443.13	Professional	TC	$95.23	$167.80	$443.13
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $182.76 / $215.34 / $271.33	Facility	26	$182.76	$215.34	$271.33
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $288.05 / $329.20 / $471.03	Professional		$288.05	$329.20	$471.03
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $175.59 / $215.34 / $287.54	Professional	26	$175.59	$215.34	$287.54
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $106.43 / $113.86 / $154.10	Professional	TC	$106.43	$113.86	$154.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.22 / $205.38 / $351.50	Professional		$91.22	$205.38	$351.50
United Facility/Professional Professional Modifier Low / Median / High Price $298.18 / $341.96 / $477.41	Professional		$298.18	$341.96	$477.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $184.14 / $213.87 / $309.29	Professional	26	$184.14	$213.87	$309.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.06 / $130.03 / $178.28	Professional	TC	$110.06	$130.03	$178.28