Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.73 / $77.73 / $77.73	Facility	26	$77.73	$77.73	$77.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.85 / $252.85 / $371.00	Professional		$192.85	$252.85	$371.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.56 / $64.14 / $92.28	Professional	26	$54.56	$64.14	$92.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.87 / $175.12 / $304.33	Professional	TC	$134.87	$175.12	$304.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.09 / $58.89 / $58.89	Professional	26	$46.09	$58.89	$58.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.07 / $283.38 / $402.69	Professional		$93.07	$283.38	$402.69
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.80 / $94.80 / $94.80	Professional	26	$94.80	$94.80	$94.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.52 / $399.17 / $665.54	Professional		$246.52	$399.17	$665.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.40 / $75.08 / $147.63	Professional	26	$46.40	$75.08	$147.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $176.10 / $277.14 / $496.16	Professional	TC	$176.10	$277.14	$496.16
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $49.56 / $77.73 / $77.73	Facility	26	$49.56	$77.73	$77.73
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $215.78 / $276.56 / $390.84	Professional		$215.78	$276.56	$390.84
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $49.56 / $64.14 / $105.62	Professional	26	$49.56	$64.14	$105.62
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $149.07 / $227.00 / $330.00	Professional	TC	$149.07	$227.00	$330.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $152.02 / $233.43	Professional		$35.58	$152.02	$233.43
United Facility/Professional Professional Modifier Low / Median / High Price $216.07 / $318.88 / $461.37	Professional		$216.07	$318.88	$461.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.52 / $66.53 / $107.29	Professional	26	$57.52	$66.53	$107.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $153.91 / $265.02 / $379.87	Professional	TC	$153.91	$265.02	$379.87