Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.97	Facility	26	$72.95	$72.95	$72.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $303.82 / $522.50	Professional		$250.00	$303.82	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.12 / $72.97 / $154.00	Professional	26	$59.12	$72.97	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $228.28 / $368.50	Professional	TC	$187.50	$228.28	$368.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.06 / $72.06 / $72.06	Professional	26	$72.06	$72.06	$72.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $292.00 / $396.87	Professional		$79.48	$292.00	$396.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.48 / $89.48 / $89.48	Professional	26	$89.48	$89.48	$89.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.27 / $495.35 / $878.69	Professional		$271.27	$495.35	$878.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.37 / $69.01 / $150.00	Professional	26	$43.37	$69.01	$150.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $209.21 / $366.78 / $639.41	Professional	TC	$209.21	$366.78	$639.41
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.66 / $72.95 / $72.97	Facility	26	$46.66	$72.95	$72.97
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $248.84 / $396.97 / $568.14	Professional		$248.84	$396.97	$568.14
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.66 / $72.97 / $140.00	Professional	26	$46.66	$72.97	$140.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $185.95 / $340.00 / $492.49	Professional	TC	$185.95	$340.00	$492.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $184.48 / $277.93	Professional		$35.58	$184.48	$277.93
United Facility/Professional Professional Modifier Low / Median / High Price $251.38 / $438.64 / $662.11	Professional		$251.38	$438.64	$662.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.18 / $62.66 / $99.12	Professional	26	$53.18	$62.66	$99.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.12 / $349.23 / $542.39	Professional	TC	$195.12	$349.23	$542.39