Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.96 / $32.97 / $32.97	Facility	26	$32.96	$32.97	$32.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $119.20 / $177.45	Professional		$90.73	$119.20	$177.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.26 / $28.55 / $51.19	Professional	26	$24.26	$28.55	$51.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.45 / $97.94 / $137.88	Professional	TC	$66.45	$97.94	$137.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.76 / $120.76 / $120.76	Professional		$120.76	$120.76	$120.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.34 / $195.55 / $446.99	Professional		$41.34	$195.55	$446.99
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.58 / $44.21 / $44.21	Professional	26	$37.58	$44.21	$44.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.15 / $32.15 / $32.15	Facility	26	$32.15	$32.15	$32.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.26 / $135.36 / $276.14	Professional		$92.26	$135.36	$276.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.65 / $34.47 / $69.40	Professional	26	$21.65	$34.47	$69.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.34 / $103.94 / $216.89	Professional	TC	$67.34	$103.94	$216.89
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $22.77 / $22.77 / $32.97	Facility	26	$22.77	$22.77	$32.97
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $83.84 / $120.76 / $192.24	Professional		$83.84	$120.76	$192.24
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.77 / $29.80 / $51.08	Professional	26	$22.77	$29.80	$51.08
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $61.07 / $95.58 / $158.18	Professional	TC	$61.07	$95.58	$158.18
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 $88.41 / $110.89 / $158.33	Professional		$88.41	$110.89	$158.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.28 / $31.42 / $87.90	Professional	26	$25.28	$31.42	$87.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.59 / $90.16 / $121.03	Professional	TC	$69.59	$90.16	$121.03