Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.06 / $69.06 / $87.04	Facility	26	$69.06	$69.06	$87.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.91 / $232.72 / $410.45	Professional		$161.91	$232.72	$410.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.58 / $68.14 / $171.05	Professional	26	$48.58	$68.14	$171.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.98 / $175.49 / $302.37	Professional	TC	$104.98	$175.49	$302.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.33 / $62.24 / $62.24	Professional		$56.33	$62.24	$62.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $68.28 / $100.68	Professional	26	$41.11	$68.28	$100.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.18 / $180.07 / $270.11	Professional		$79.18	$180.07	$270.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.98 / $84.68 / $84.68	Professional	26	$71.98	$84.68	$84.68
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $156.05 / $156.05 / $156.05	Professional	TC	$156.05	$156.05	$156.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.34 / $61.34 / $61.34	Facility	26	$61.34	$61.34	$61.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.58 / $280.54 / $447.61	Professional		$146.58	$280.54	$447.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.28 / $64.79 / $131.79	Professional	26	$40.28	$64.79	$131.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.23 / $171.70 / $328.30	Professional	TC	$97.23	$171.70	$328.30
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $43.60 / $69.06 / $72.53	Facility	26	$43.60	$69.06	$72.53
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $167.87 / $189.15 / $360.52	Professional		$167.87	$189.15	$360.52
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $43.60 / $67.95 / $171.05	Professional	26	$43.60	$67.95	$171.05
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $112.71 / $144.96 / $267.01	Professional	TC	$112.71	$144.96	$267.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $108.90 / $159.69	Professional		$34.95	$108.90	$159.69
United Facility/Professional Professional Modifier Low / Median / High Price $153.36 / $227.03 / $348.15	Professional		$153.36	$227.03	$348.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.50 / $57.74 / $86.61	Professional	26	$50.50	$57.74	$86.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.77 / $128.40 / $238.18	Professional	TC	$98.77	$128.40	$238.18