Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.22 / $131.22 / $137.79	Facility	26	$131.22	$131.22	$137.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $422.31 / $522.50 / $728.66	Professional		$422.31	$522.50	$728.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.64 / $140.00 / $305.00	Professional	26	$103.64	$140.00	$305.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $325.86 / $395.60 / $589.57	Professional	TC	$325.86	$395.60	$589.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $299.08 / $299.08 / $317.14	Professional		$299.08	$299.08	$317.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.16 / $101.30 / $194.16	Professional	26	$79.16	$101.30	$194.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $315.25 / $662.32 / $1,547.48	Professional		$315.25	$662.32	$1,547.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $162.44 / $162.44 / $162.44	Professional	26	$162.44	$162.44	$162.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $456.90 / $802.67 / $1,311.17	Professional		$456.90	$802.67	$1,311.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.92 / $124.41 / $250.28	Professional	26	$76.92	$124.41	$250.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $362.79 / $595.77 / $1,112.30	Professional	TC	$362.79	$595.77	$1,112.30
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $83.90 / $131.22 / $137.79	Facility	26	$83.90	$131.22	$137.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $446.50 / $526.83 / $773.17	Professional		$446.50	$526.83	$773.17
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $83.90 / $131.22 / $230.21	Professional	26	$83.90	$131.22	$230.21
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $440.29 / $624.84	Professional	TC	$335.00	$440.29	$624.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $293.53 / $456.15	Professional		$93.51	$293.53	$456.15
United Facility/Professional Professional Modifier Low / Median / High Price $447.57 / $629.05 / $1,070.28	Professional		$447.57	$629.05	$1,070.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.61 / $111.00 / $177.91	Professional	26	$95.61	$111.00	$177.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $331.35 / $458.63 / $893.21	Professional	TC	$331.35	$458.63	$893.21