Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.85 / $23.85 / $25.04	Facility	26	$23.85	$23.85	$25.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $91.14 / $140.52	Professional		$73.73	$91.14	$140.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $20.81 / $52.59	Professional	26	$18.16	$20.81	$52.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.57 / $75.54 / $111.25	Professional	TC	$55.57	$75.54	$111.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.26 / $95.26 / $119.08	Professional		$95.26	$95.26	$119.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.50 / $19.84 / $19.84	Professional	26	$15.50	$19.84	$19.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.88 / $146.91 / $176.29	Professional		$29.88	$146.91	$176.29
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.96 / $31.96 / $31.96	Professional	26	$31.96	$31.96	$31.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.72 / $22.72 / $22.72	Facility	26	$22.72	$22.72	$22.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.83 / $103.26 / $210.06	Professional		$73.83	$103.26	$210.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.47 / $25.47 / $48.58	Professional	26	$15.47	$25.47	$48.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.05 / $80.09 / $165.78	Professional	TC	$56.05	$80.09	$165.78
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $15.63 / $23.85 / $25.04	Facility	26	$15.63	$23.85	$25.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $60.50 / $102.56 / $161.94	Professional		$60.50	$102.56	$161.94
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $15.63 / $21.50 / $51.75	Professional	26	$15.63	$21.50	$51.75
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.65 / $82.73 / $132.44	Professional	TC	$44.65	$82.73	$132.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.85 / $82.65 / $121.44	Professional		$56.85	$82.65	$121.44
United Facility/Professional Professional Modifier Low / Median / High Price $75.78 / $89.82 / $155.06	Professional		$75.78	$89.82	$155.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.66 / $22.62 / $32.60	Professional	26	$18.66	$22.62	$32.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.50 / $68.27 / $94.67	Professional	TC	$57.50	$68.27	$94.67