Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.54 / $91.54 / $91.54	Facility	26	$91.54	$91.54	$91.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.83 / $314.97 / $522.50	Professional		$251.83	$314.97	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.92 / $91.54 / $318.01	Professional	26	$71.92	$91.54	$318.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.61 / $223.43 / $368.50	Professional	TC	$181.61	$223.43	$368.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.61 / $54.61 / $54.61	Professional	26	$54.61	$54.61	$54.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.08 / $322.08 / $448.19	Professional		$105.08	$322.08	$448.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.38 / $112.38 / $112.38	Professional	26	$112.38	$112.38	$112.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.40 / $81.40 / $81.40	Facility	26	$81.40	$81.40	$81.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.37 / $529.72 / $939.64	Professional		$302.37	$529.72	$939.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.44 / $80.09 / $156.09	Professional	26	$52.44	$80.09	$156.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.26 / $377.61 / $657.45	Professional	TC	$221.26	$377.61	$657.45
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.92 / $46.92 / $91.54	Facility	26	$46.92	$46.92	$91.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $269.95 / $425.82 / $603.00	Professional		$269.95	$425.82	$603.00
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.92 / $91.54 / $311.52	Professional	26	$46.92	$91.54	$311.52
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $190.89 / $348.53 / $511.51	Professional	TC	$190.89	$348.53	$511.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $169.09 / $297.67	Professional		$93.51	$169.09	$297.67
United Facility/Professional Professional Modifier Low / Median / High Price $279.33 / $467.19 / $641.26	Professional		$279.33	$467.19	$641.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.06 / $76.87 / $223.45	Professional	26	$55.06	$76.87	$223.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.51 / $402.35 / $586.01	Professional	TC	$200.51	$402.35	$586.01