Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.76 / $109.76 / $109.76	Facility	26	$109.76	$109.76	$109.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.09 / $475.00 / $926.80	Professional		$346.09	$475.00	$926.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.12 / $140.00 / $389.19	Professional	26	$87.12	$140.00	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $260.22 / $335.00 / $507.50	Professional	TC	$260.22	$335.00	$507.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.26 / $169.92 / $169.92	Professional	26	$83.26	$169.92	$169.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.50 / $479.23 / $681.01	Professional		$125.50	$479.23	$681.01
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.22 / $134.22 / $134.22	Professional	26	$134.22	$134.22	$134.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.95 / $96.95 / $96.95	Facility	26	$96.95	$96.95	$96.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.84 / $597.17 / $1,007.41	Professional		$363.84	$597.17	$1,007.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.38 / $104.29 / $210.00	Professional	26	$64.38	$104.29	$210.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $265.51 / $460.94 / $768.02	Professional	TC	$265.51	$460.94	$768.02
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $70.80 / $109.76 / $111.73	Facility	26	$70.80	$109.76	$111.73
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $363.93 / $448.45 / $845.00	Professional		$363.93	$448.45	$845.00
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.80 / $112.41 / $347.82	Professional	26	$70.80	$112.41	$347.82
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $269.51 / $337.35 / $608.30	Professional	TC	$269.51	$337.35	$608.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.24 / $255.36 / $371.09	Professional		$93.24	$255.36	$371.09
United Facility/Professional Professional Modifier Low / Median / High Price $378.60 / $474.05 / $678.39	Professional		$378.60	$474.05	$678.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.04 / $95.95 / $147.84	Professional	26	$80.04	$95.95	$147.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $273.18 / $364.02 / $549.13	Professional	TC	$273.18	$364.02	$549.13