Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.64 / $109.64 / $138.13	Facility	26	$109.64	$109.64	$138.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.87 / $353.39 / $522.50	Professional		$282.87	$353.39	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.49 / $109.64 / $154.00	Professional	26	$85.49	$109.64	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $196.45 / $243.75 / $368.50	Professional	TC	$196.45	$243.75	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $230.63 / $230.63 / $230.63	Professional		$230.63	$230.63	$230.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.77 / $84.36 / $84.36	Professional	26	$62.77	$84.36	$84.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.49 / $348.98 / $464.17	Professional		$126.49	$348.98	$464.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $135.28 / $135.28 / $135.28	Professional	26	$135.28	$135.28	$135.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $311.04 / $311.04 / $311.04	Professional	TC	$311.04	$311.04	$311.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.16 / $97.16 / $97.16	Facility	26	$97.16	$97.16	$97.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.60 / $560.90 / $998.53	Professional		$294.60	$560.90	$998.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.87 / $107.08 / $209.42	Professional	26	$64.87	$107.08	$209.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.45 / $384.14 / $699.97	Professional	TC	$216.45	$384.14	$699.97
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $75.23 / $109.64 / $109.64	Facility	26	$75.23	$109.64	$109.64
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $302.07 / $430.32 / $580.92	Professional		$302.07	$430.32	$580.92
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $75.23 / $107.16 / $154.00	Professional	26	$75.23	$107.16	$154.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $206.82 / $342.52 / $461.60	Professional	TC	$206.82	$342.52	$461.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $196.97 / $304.54	Professional		$93.51	$196.97	$304.54
United Facility/Professional Professional Modifier Low / Median / High Price $296.94 / $461.02 / $792.02	Professional		$296.94	$461.02	$792.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.05 / $98.97 / $142.01	Professional	26	$83.05	$98.97	$142.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $207.48 / $274.57 / $575.23	Professional	TC	$207.48	$274.57	$575.23