Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.12 / $110.12 / $110.12	Facility	26	$110.12	$110.12	$110.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $355.49 / $475.00 / $631.59	Professional		$355.49	$475.00	$631.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.69 / $140.00 / $380.16	Professional	26	$88.69	$140.00	$380.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.31 / $335.00 / $501.95	Professional	TC	$269.31	$335.00	$501.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $271.48 / $271.48 / $342.91	Professional		$271.48	$271.48	$342.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.04 / $83.57 / $160.82	Professional	26	$64.04	$83.57	$160.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.99 / $497.69 / $628.66	Professional		$125.99	$497.69	$628.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.75 / $134.75 / $134.75	Professional	26	$134.75	$134.75	$134.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $97.25 / $97.25	Facility	26	$97.25	$97.25	$97.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $419.05 / $751.88 / $1,426.58	Professional		$419.05	$751.88	$1,426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.69 / $104.81 / $211.11	Professional	26	$64.69	$104.81	$211.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.43 / $564.58 / $1,017.46	Professional	TC	$323.43	$564.58	$1,017.46
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $70.01 / $110.12 / $112.10	Facility	26	$70.01	$110.12	$112.10
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $403.24 / $529.33 / $780.69	Professional		$403.24	$529.33	$780.69
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.01 / $112.39 / $337.51	Professional	26	$70.01	$112.39	$337.51
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $306.93 / $398.48 / $665.04	Professional	TC	$306.93	$398.48	$665.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $262.62 / $417.79	Professional		$93.51	$262.62	$417.79
United Facility/Professional Professional Modifier Low / Median / High Price $382.43 / $679.70 / $1,035.21	Professional		$382.43	$679.70	$1,035.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.98 / $94.52 / $148.93	Professional	26	$79.98	$94.52	$148.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $303.51 / $607.02 / $905.22	Professional	TC	$303.51	$607.02	$905.22