Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.37 / $73.37 / $92.44	Facility	26	$73.37	$73.37	$92.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.08 / $393.75 / $522.50	Professional		$237.08	$393.75	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $118.13 / $191.25	Professional	26	$60.39	$118.13	$191.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.70 / $306.97 / $368.50	Professional	TC	$176.70	$306.97	$368.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $45.98 / $75.25	Professional	26	$43.65	$45.98	$75.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.16 / $270.86 / $350.61	Professional		$84.16	$270.86	$350.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.01 / $90.01 / $90.01	Professional	26	$90.01	$90.01	$90.01
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 $270.18 / $470.56 / $886.59	Professional		$270.18	$470.56	$886.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.64 / $70.06 / $140.97	Professional	26	$43.64	$70.06	$140.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $209.06 / $345.35 / $606.20	Professional	TC	$209.06	$345.35	$606.20
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.92 / $73.37 / $74.69	Facility	26	$46.92	$73.37	$74.69
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $246.93 / $403.06 / $534.34	Professional		$246.93	$403.06	$534.34
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.92 / $73.37 / $145.65	Professional	26	$46.92	$73.37	$145.65
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $335.00 / $462.98	Professional	TC	$187.50	$335.00	$462.98
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 $247.20 / $445.66 / $659.60	Professional		$247.20	$445.66	$659.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.84 / $63.06 / $99.66	Professional	26	$52.84	$63.06	$99.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.08 / $356.67 / $543.46	Professional	TC	$171.08	$356.67	$543.46