Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.33 / $77.33 / $97.43	Facility	26	$77.33	$77.33	$97.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.45 / $268.89 / $444.84	Professional		$206.45	$268.89	$444.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.69 / $77.31 / $90.99	Professional	26	$57.69	$77.31	$90.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.76 / $191.58 / $375.83	Professional	TC	$148.76	$191.58	$375.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.09 / $46.09 / $88.01	Professional	26	$46.09	$46.09	$88.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.18 / $302.30 / $381.85	Professional		$94.18	$302.30	$381.85
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.80 / $94.80 / $94.80	Professional	26	$94.80	$94.80	$94.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $262.32 / $400.86 / $745.43	Professional		$262.32	$400.86	$745.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.75 / $82.41 / $157.58	Professional	26	$48.75	$82.41	$157.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.10 / $300.91 / $530.66	Professional	TC	$190.10	$300.91	$530.66
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $56.38 / $56.38 / $97.43	Facility	26	$56.38	$56.38	$97.43
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $229.93 / $307.45 / $444.84	Professional		$229.93	$307.45	$444.84
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $56.38 / $70.66 / $116.00	Professional	26	$56.38	$70.66	$116.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $163.22 / $251.08 / $375.83	Professional	TC	$163.22	$251.08	$375.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $171.84 / $242.59	Professional		$35.58	$171.84	$242.59
United Facility/Professional Professional Modifier Low / Median / High Price $231.81 / $341.66 / $523.02	Professional		$231.81	$341.66	$523.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.14 / $72.34 / $106.29	Professional	26	$58.14	$72.34	$106.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $166.07 / $265.44 / $374.80	Professional	TC	$166.07	$265.44	$374.80