Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.23 / $20.23 / $25.48	Facility	26	$20.23	$20.23	$25.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $74.97 / $135.71	Professional		$61.64	$74.97	$135.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.39 / $17.34 / $30.35	Professional	26	$15.39	$17.34	$30.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $54.98 / $104.45	Professional	TC	$46.00	$54.98	$104.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.83 / $65.83 / $65.83	Professional		$65.83	$65.83	$65.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.68 / $16.69 / $16.69	Professional	26	$12.68	$16.69	$16.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.39 / $112.94 / $143.41	Professional		$25.39	$112.94	$143.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.16 / $27.16 / $27.16	Professional	26	$27.16	$27.16	$27.16
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.66 / $100.66 / $100.66	Professional	TC	$100.66	$100.66	$100.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.00 / $90.15 / $171.08	Professional		$59.00	$90.15	$171.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.37 / $21.48 / $42.78	Professional	26	$13.37	$21.48	$42.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.42 / $66.40 / $133.19	Professional	TC	$46.42	$66.40	$133.19
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $20.23 / $25.48	Facility	26	$13.50	$20.23	$25.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $75.28 / $136.22	Professional		$50.72	$75.28	$136.22
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.50 / $17.55 / $33.60	Professional	26	$13.50	$17.55	$33.60
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $37.22 / $56.75 / $104.45	Professional	TC	$37.22	$56.75	$104.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.34 / $65.54 / $89.34	Professional		$52.34	$65.54	$89.34
United Facility/Professional Professional Modifier Low / Median / High Price $61.33 / $75.00 / $105.83	Professional		$61.33	$75.00	$105.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.36 / $19.37 / $28.97	Professional	26	$16.36	$19.37	$28.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.63 / $54.89 / $76.86	Professional	TC	$47.63	$54.89	$76.86