Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.62 / $131.62 / $138.21	Facility	26	$131.62	$131.62	$138.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $405.28 / $497.93 / $699.55	Professional		$405.28	$497.93	$699.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.00 / $140.00 / $305.45	Professional	26	$104.00	$140.00	$305.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.45 / $366.30 / $500.38	Professional	TC	$302.45	$366.30	$500.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.16 / $101.30 / $145.62	Professional	26	$79.16	$101.30	$145.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.88 / $623.41 / $1,456.59	Professional		$151.88	$623.41	$1,456.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $162.44 / $162.44 / $162.44	Professional	26	$162.44	$162.44	$162.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $460.70 / $460.70 / $460.70	Professional	TC	$460.70	$460.70	$460.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.87 / $116.87 / $116.87	Facility	26	$116.87	$116.87	$116.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $428.67 / $763.12 / $1,254.55	Professional		$428.67	$763.12	$1,254.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.92 / $122.39 / $250.28	Professional	26	$76.92	$122.39	$250.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $334.60 / $556.38 / $1,071.00	Professional	TC	$334.60	$556.38	$1,071.00
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $83.90 / $131.62 / $136.09	Facility	26	$83.90	$131.62	$136.09
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $428.90 / $497.93 / $746.90	Professional		$428.90	$497.93	$746.90
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $83.90 / $131.63 / $234.00	Professional	26	$83.90	$131.63	$234.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $320.49 / $411.18 / $549.45	Professional	TC	$320.49	$411.18	$549.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $287.59 / $426.20	Professional		$93.51	$287.59	$426.20
United Facility/Professional Professional Modifier Low / Median / High Price $425.64 / $569.20 / $1,071.14	Professional		$425.64	$569.20	$1,071.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.32 / $110.65 / $167.46	Professional	26	$95.32	$110.65	$167.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $317.55 / $426.24 / $830.27	Professional	TC	$317.55	$426.24	$830.27