Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.38 / $89.38 / $112.61	Facility	26	$89.38	$89.38	$112.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.35 / $475.00 / $630.00	Professional		$293.35	$475.00	$630.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.48 / $127.28 / $189.00	Professional	26	$70.48	$127.28	$189.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $222.87 / $335.00 / $470.23	Professional	TC	$222.87	$335.00	$470.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.05 / $88.61 / $88.61	Professional	26	$51.05	$88.61	$88.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.24 / $482.07 / $608.92	Professional		$128.24	$482.07	$608.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.72 / $109.72 / $109.72	Professional	26	$109.72	$109.72	$109.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.51 / $562.11 / $1,030.91	Professional		$326.51	$562.11	$1,030.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.70 / $84.22 / $171.71	Professional	26	$52.70	$84.22	$171.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $254.53 / $453.74 / $824.96	Professional	TC	$254.53	$453.74	$824.96
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $56.64 / $89.37 / $93.84	Facility	26	$56.64	$89.37	$93.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $341.98 / $417.02 / $630.00	Professional		$341.98	$417.02	$630.00
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $56.64 / $89.38 / $154.00	Professional	26	$56.64	$89.38	$154.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $264.80 / $360.38 / $499.00	Professional	TC	$264.80	$360.38	$499.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.71 / $226.14 / $343.14	Professional		$61.71	$226.14	$343.14
United Facility/Professional Professional Modifier Low / Median / High Price $373.31 / $491.44 / $690.01	Professional		$373.31	$491.44	$690.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.78 / $76.27 / $120.55	Professional	26	$66.78	$76.27	$120.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $292.88 / $397.91 / $575.48	Professional	TC	$292.88	$397.91	$575.48