Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.24 / $109.24 / $114.70	Facility	26	$109.24	$109.24	$114.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.74 / $391.08 / $522.50	Professional		$279.74	$391.08	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.16 / $111.94 / $154.00	Professional	26	$85.16	$111.94	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.91 / $279.14 / $368.50	Professional	TC	$191.91	$279.14	$368.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.54 / $84.04 / $84.04	Professional	26	$62.54	$84.04	$84.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.99 / $383.20 / $491.81	Professional		$125.99	$383.20	$491.81
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.75 / $134.75 / $134.75	Professional	26	$134.75	$134.75	$134.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $303.58 / $303.58 / $303.58	Professional	TC	$303.58	$303.58	$303.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.82 / $96.82 / $96.82	Facility	26	$96.82	$96.82	$96.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.95 / $534.96 / $980.49	Professional		$290.95	$534.96	$980.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.96 / $103.43 / $208.68	Professional	26	$63.96	$103.43	$208.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $212.80 / $375.11 / $699.97	Professional	TC	$212.80	$375.11	$699.97
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $70.22 / $70.22 / $109.24	Facility	26	$70.22	$70.22	$109.24
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $296.77 / $420.01 / $588.01	Professional		$296.77	$420.01	$588.01
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.22 / $109.24 / $156.00	Professional	26	$70.22	$109.24	$156.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $201.86 / $335.00 / $457.87	Professional	TC	$201.86	$335.00	$457.87
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 $291.83 / $382.73 / $696.90	Professional		$291.83	$382.73	$696.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.66 / $94.04 / $148.34	Professional	26	$81.66	$94.04	$148.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $203.59 / $272.41 / $564.79	Professional	TC	$203.59	$272.41	$564.79