Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.15 / $138.15 / $145.06	Facility	26	$138.15	$138.15	$145.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $461.08 / $575.09 / $804.13	Professional		$461.08	$575.09	$804.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.02 / $140.00 / $379.50	Professional	26	$109.02	$140.00	$379.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $425.73 / $638.59	Professional	TC	$335.00	$425.73	$638.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $247.06 / $247.06 / $247.06	Professional		$247.06	$247.06	$247.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.12 / $101.90 / $210.89	Professional	26	$83.12	$101.90	$210.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $159.35 / $710.62 / $959.34	Professional		$159.35	$710.62	$959.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $170.43 / $170.43 / $170.43	Professional	26	$170.43	$170.43	$170.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.33 / $122.33 / $122.33	Facility	26	$122.33	$122.33	$122.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $490.68 / $922.13 / $1,433.29	Professional		$490.68	$922.13	$1,433.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.28 / $130.19 / $261.79	Professional	26	$80.28	$130.19	$261.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $382.49 / $713.65 / $1,261.19	Professional	TC	$382.49	$713.65	$1,261.19
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $87.87 / $138.15 / $145.06	Facility	26	$87.87	$138.15	$145.06
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $599.35 / $865.96	Professional		$475.00	$599.35	$865.96
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $87.87 / $138.16 / $332.35	Professional	26	$87.87	$138.16	$332.35
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $511.48 / $694.20	Professional	TC	$335.00	$511.48	$694.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $355.38 / $536.77	Professional		$93.51	$355.38	$536.77
United Facility/Professional Professional Modifier Low / Median / High Price $518.23 / $750.77 / $1,136.58	Professional		$518.23	$750.77	$1,136.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.88 / $117.96 / $187.18	Professional	26	$100.88	$117.96	$187.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $409.56 / $637.37 / $980.01	Professional	TC	$409.56	$637.37	$980.01