Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.43 / $98.43 / $98.44	Facility	26	$98.43	$98.43	$98.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.24 / $340.04 / $543.33	Professional		$227.24	$340.04	$543.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $83.38 / $129.94	Professional	26	$62.17	$83.38	$129.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.63 / $244.93 / $456.29	Professional	TC	$144.63	$244.93	$456.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.24 / $172.93 / $172.93	Professional		$133.24	$172.93	$172.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.64 / $71.15 / $135.30	Professional	26	$56.64	$71.15	$135.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.04 / $254.84 / $358.08	Professional		$113.04	$254.84	$358.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.90 / $120.90 / $120.90	Professional	26	$120.90	$120.90	$120.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $237.01 / $237.01 / $237.01	Professional	TC	$237.01	$237.01	$237.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.25 / $87.25 / $87.25	Facility	26	$87.25	$87.25	$87.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.97 / $381.77 / $668.47	Professional		$235.97	$381.77	$668.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.36 / $90.00 / $180.28	Professional	26	$58.36	$90.00	$180.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.91 / $266.23 / $493.59	Professional	TC	$157.91	$266.23	$493.59
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $56.38 / $98.43 / $100.21	Facility	26	$56.38	$98.43	$100.21
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $250.11 / $283.99 / $463.90	Professional		$250.11	$283.99	$463.90
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $56.38 / $87.04 / $144.30	Professional	26	$56.38	$87.04	$144.30
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $170.88 / $221.18 / $345.93	Professional	TC	$170.88	$221.18	$345.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $137.18 / $260.38	Professional		$93.51	$137.18	$260.38
United Facility/Professional Professional Modifier Low / Median / High Price $236.23 / $315.88 / $470.94	Professional		$236.23	$315.88	$470.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.45 / $82.45 / $119.96	Professional	26	$66.45	$82.45	$119.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $160.66 / $231.40 / $338.46	Professional	TC	$160.66	$231.40	$338.46