Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.28 / $52.28 / $72.56	Facility	26	$52.28	$52.28	$72.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.43 / $352.65 / $508.81	Professional		$292.43	$352.65	$508.81
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $146.44 / $187.09 / $205.30	Professional	52	$146.44	$187.09	$205.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.25 / $307.94 / $450.21	Professional	TC	$251.25	$307.94	$450.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.23 / $563.51 / $661.51	Professional		$66.23	$563.51	$661.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $524.08 / $524.08 / $524.08	Professional	TC	$524.08	$524.08	$524.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.46 / $351.48 / $451.74	Professional		$47.46	$351.48	$451.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $334.98 / $524.55 / $1,635.85	Professional		$334.98	$524.55	$1,635.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $289.95 / $452.76 / $1,447.37	Professional	TC	$289.95	$452.76	$1,447.37
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $42.88 / $52.28 / $72.56	Facility	26	$42.88	$52.28	$72.56
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $286.18 / $374.98 / $512.44	Professional		$286.18	$374.98	$512.44
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $163.69 / $203.35 / $254.41	Professional	52	$163.69	$203.35	$254.41
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $243.30 / $321.07 / $446.56	Professional	TC	$243.30	$321.07	$446.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.68 / $335.13 / $501.33	Professional		$35.68	$335.13	$501.33
United Facility/Professional Professional Modifier Low / Median / High Price $303.08 / $374.40 / $532.29	Professional		$303.08	$374.40	$532.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $258.52 / $323.14 / $456.11	Professional	TC	$258.52	$323.14	$456.11