Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.36 / $109.36 / $137.79	Facility	26	$109.36	$109.36	$137.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $256.10 / $370.00 / $618.64	Professional		$256.10	$370.00	$618.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.34 / $91.56 / $128.65	Professional	26	$78.34	$91.56	$128.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.12 / $285.00 / $508.96	Professional	TC	$170.12	$285.00	$508.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $71.45 / $71.45 / $71.45	Professional	26	$71.45	$71.45	$71.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.13 / $385.99 / $553.96	Professional		$140.13	$385.99	$553.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.75 / $134.75 / $134.75	Professional	26	$134.75	$134.75	$134.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $282.77 / $474.29 / $842.84	Professional		$282.77	$474.29	$842.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.11 / $102.18 / $209.72	Professional	26	$64.11	$102.18	$209.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.61 / $352.65 / $672.83	Professional	TC	$199.61	$352.65	$672.83
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $71.48 / $71.48 / $137.79	Facility	26	$71.48	$71.48	$137.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $289.66 / $360.13 / $511.60	Professional		$289.66	$360.13	$511.60
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $71.48 / $92.92 / $164.04	Professional	26	$71.48	$92.92	$164.04
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $194.68 / $288.66 / $427.55	Professional	TC	$194.68	$288.66	$427.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $169.31 / $297.67	Professional		$93.51	$169.31	$297.67
United Facility/Professional Professional Modifier Low / Median / High Price $317.02 / $450.44 / $608.61	Professional		$317.02	$450.44	$608.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.89 / $93.71 / $149.56	Professional	26	$80.89	$93.71	$149.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $216.02 / $303.10 / $492.31	Professional	TC	$216.02	$303.10	$492.31