Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.25 / $74.25 / $88.30	Facility	26	$74.25	$74.25	$88.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $258.79 / $450.50	Professional		$171.00	$258.79	$450.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $74.25 / $158.22	Professional	26	$52.46	$74.25	$158.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $169.69 / $377.04	Professional	TC	$119.70	$169.69	$377.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.93 / $67.67 / $84.59	Professional	26	$47.93	$67.67	$84.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.15 / $204.37 / $281.01	Professional		$85.15	$204.37	$281.01
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.07 / $91.07 / $91.07	Professional	26	$91.07	$91.07	$91.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $65.98 / $65.98	Facility	26	$65.98	$65.98	$65.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.87 / $342.90 / $539.25	Professional		$198.87	$342.90	$539.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.10 / $69.87 / $142.66	Professional	26	$44.10	$69.87	$142.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.41 / $238.54 / $402.89	Professional	TC	$141.41	$238.54	$402.89
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $47.71 / $74.25 / $88.30	Facility	26	$47.71	$74.25	$88.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $185.14 / $229.46 / $412.50	Professional		$185.14	$229.46	$412.50
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $47.71 / $73.45 / $130.33	Professional	26	$47.71	$73.45	$130.33
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $123.84 / $181.75 / $316.74	Professional	TC	$123.84	$181.75	$316.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $116.15 / $192.46	Professional		$35.58	$116.15	$192.46
United Facility/Professional Professional Modifier Low / Median / High Price $183.92 / $273.63 / $395.43	Professional		$183.92	$273.63	$395.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.82 / $63.91 / $100.85	Professional	26	$54.82	$63.91	$100.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.49 / $194.43 / $297.22	Professional	TC	$124.49	$194.43	$297.22