Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.84 / $73.84 / $73.84	Facility	26	$73.84	$73.84	$73.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.50 / $298.76 / $563.50	Professional		$195.50	$298.76	$563.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $73.84 / $88.26	Professional	26	$52.78	$73.84	$88.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $137.32 / $220.00 / $489.53	Professional	TC	$137.32	$220.00	$489.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.93 / $53.48 / $114.51	Professional	26	$43.93	$53.48	$114.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.65 / $316.36 / $658.03	Professional		$84.65	$316.36	$658.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.54 / $90.54 / $90.54	Professional	26	$90.54	$90.54	$90.54
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 $236.86 / $391.99 / $693.14	Professional		$236.86	$391.99	$693.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.10 / $69.48 / $141.93	Professional	26	$44.10	$69.48	$141.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.21 / $294.38 / $503.75	Professional	TC	$183.21	$294.38	$503.75
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $47.71 / $73.84 / $75.17	Facility	26	$47.71	$73.84	$75.17
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $213.79 / $285.56 / $424.51	Professional		$213.79	$285.56	$424.51
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $47.71 / $67.28 / $98.38	Professional	26	$47.71	$67.28	$98.38
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $153.24 / $237.85 / $385.78	Professional	TC	$153.24	$237.85	$385.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $152.02 / $233.43	Professional		$35.58	$152.02	$233.43
United Facility/Professional Professional Modifier Low / Median / High Price $214.90 / $310.70 / $469.76	Professional		$214.90	$310.70	$469.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.09 / $64.33 / $178.05	Professional	26	$54.09	$64.33	$178.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.76 / $238.76 / $360.42	Professional	TC	$159.76	$238.76	$360.42