Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.73 / $77.73 / $97.93	Facility	26	$77.73	$77.73	$97.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.54 / $236.40 / $608.04	Professional		$180.54	$236.40	$608.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.69 / $77.73 / $93.15	Professional	26	$57.69	$77.73	$93.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.85 / $158.66 / $473.68	Professional	TC	$122.85	$158.66	$473.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.40 / $147.40 / $147.40	Professional		$147.40	$147.40	$147.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.09 / $55.96 / $70.67	Professional	26	$46.09	$55.96	$70.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.64 / $223.10 / $376.47	Professional		$88.64	$223.10	$376.47
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 $196.76 / $354.90 / $664.52	Professional		$196.76	$354.90	$664.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.70 / $80.79 / $148.37	Professional	26	$47.70	$80.79	$148.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.72 / $228.41 / $454.50	Professional	TC	$131.72	$228.41	$454.50
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $55.32 / $55.32 / $97.93	Facility	26	$55.32	$55.32	$97.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $201.99 / $285.76 / $457.33	Professional		$201.99	$285.76	$457.33
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $55.32 / $71.18 / $113.23	Professional	26	$55.32	$71.18	$113.23
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $135.28 / $230.44 / $380.82	Professional	TC	$135.28	$230.44	$380.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $140.30 / $200.88	Professional		$35.58	$140.30	$200.88
United Facility/Professional Professional Modifier Low / Median / High Price $191.07 / $284.01 / $422.21	Professional		$191.07	$284.01	$422.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.96 / $72.67 / $104.22	Professional	26	$60.96	$72.67	$104.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $136.97 / $253.65 / $352.73	Professional	TC	$136.97	$253.65	$352.73