Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.85 / $31.85 / $39.54	Facility	26	$31.85	$31.85	$39.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.57 / $137.63 / $219.82	Professional		$97.57	$137.63	$219.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.64 / $31.85 / $41.62	Professional	26	$23.64	$31.85	$41.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.93 / $107.21 / $178.18	Professional	TC	$73.93	$107.21	$178.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.99 / $124.99 / $124.99	Professional		$124.99	$124.99	$124.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.38 / $25.38 / $25.38	Professional	26	$25.38	$25.38	$25.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.84 / $231.86 / $429.83	Professional		$39.84	$231.86	$429.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $42.61 / $42.61	Professional	26	$36.22	$42.61	$42.61
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $164.04 / $164.04 / $164.04	Professional	TC	$164.04	$164.04	$164.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $30.37	Facility	26	$30.37	$30.37	$30.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.30 / $135.26 / $276.70	Professional		$91.30	$135.26	$276.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.80 / $32.75 / $64.31	Professional	26	$20.80	$32.75	$64.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.89 / $107.77 / $217.81	Professional	TC	$68.89	$107.77	$217.81
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $21.97 / $31.85 / $39.54	Facility	26	$21.97	$31.85	$39.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $87.01 / $135.54 / $212.48	Professional		$87.01	$135.54	$212.48
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $21.97 / $29.94 / $45.08	Professional	26	$21.97	$29.94	$45.08
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $65.04 / $99.85 / $175.70	Professional	TC	$65.04	$99.85	$175.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $108.90 / $159.69	Professional		$34.95	$108.90	$159.69
United Facility/Professional Professional Modifier Low / Median / High Price $97.07 / $115.35 / $158.83	Professional		$97.07	$115.35	$158.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.49 / $29.43 / $46.55	Professional	26	$24.49	$29.43	$46.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.37 / $88.92 / $126.23	Professional	TC	$72.37	$88.92	$126.23