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 / $74.25	Facility	26	$74.25	$74.25	$74.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.08 / $288.30 / $706.57	Professional		$218.08	$288.30	$706.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $62.84 / $98.01	Professional	26	$52.46	$62.84	$98.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.65 / $214.05 / $362.21	Professional	TC	$162.65	$214.05	$362.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.97 / $199.81 / $199.81	Professional		$149.97	$199.81	$199.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.17 / $53.78 / $56.39	Professional	26	$44.17	$53.78	$56.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.15 / $353.17 / $455.35	Professional		$85.15	$353.17	$455.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.98 / $415.06 / $667.46	Professional		$244.98	$415.06	$667.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.10 / $71.59 / $142.66	Professional	26	$44.10	$71.59	$142.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.57 / $323.37 / $562.66	Professional	TC	$184.57	$323.37	$562.66
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $47.71 / $74.25 / $74.25	Facility	26	$47.71	$74.25	$74.25
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $258.69 / $288.30 / $495.13	Professional		$258.69	$288.30	$495.13
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $47.71 / $64.00 / $106.00	Professional	26	$47.71	$64.00	$106.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $194.68 / $230.17 / $381.11	Professional	TC	$194.68	$230.17	$381.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $184.48 / $277.93	Professional		$35.58	$184.48	$277.93
United Facility/Professional Professional Modifier Low / Median / High Price $254.55 / $331.74 / $503.16	Professional		$254.55	$331.74	$503.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.36 / $62.78 / $93.66	Professional	26	$54.36	$62.78	$93.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $193.34 / $243.43 / $380.94	Professional	TC	$193.34	$243.43	$380.94