Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.87 / $107.87 / $107.87	Facility	26	$107.87	$107.87	$107.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.47 / $348.06 / $382.87	Professional		$295.47	$348.06	$382.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.09 / $91.51 / $125.69	Professional	26	$84.09	$91.51	$125.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.76 / $256.57 / $282.23	Professional	TC	$208.76	$256.57	$282.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.43 / $288.02 / $443.12	Professional		$70.43	$288.02	$443.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.18 / $133.15 / $133.15	Professional	26	$113.18	$133.15	$133.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $309.97 / $309.97 / $309.97	Professional	TC	$309.97	$309.97	$309.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.77 / $365.20 / $624.07	Professional		$269.77	$365.20	$624.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.88 / $100.33 / $174.06	Professional	26	$77.88	$100.33	$174.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.44 / $267.11 / $450.01	Professional	TC	$194.44	$267.11	$450.01
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $86.63 / $86.63 / $107.87	Facility	26	$86.63	$86.63	$107.87
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $286.06 / $324.67 / $489.56	Professional		$286.06	$324.67	$489.56
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $86.63 / $99.62 / $160.76	Professional	26	$86.63	$99.62	$160.76
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $199.44 / $221.90 / $331.39	Professional	TC	$199.44	$221.90	$331.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.22 / $201.97 / $323.46	Professional		$94.22	$201.97	$323.46
United Facility/Professional Professional Modifier Low / Median / High Price $300.58 / $385.37 / $519.48	Professional		$300.58	$385.37	$519.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.47 / $114.47 / $148.19	Professional	26	$96.47	$114.47	$148.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $202.63 / $274.11 / $363.02	Professional	TC	$202.63	$274.11	$363.02