Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.93 / $114.93 / $120.67	Facility	26	$114.93	$114.93	$120.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $262.67 / $392.31 / $624.48	Professional		$262.67	$392.31	$624.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.39 / $96.23 / $144.81	Professional	26	$82.39	$96.23	$144.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $171.98 / $309.93 / $508.96	Professional	TC	$171.98	$309.93	$508.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.02 / $88.25 / $169.40	Professional	26	$69.02	$88.25	$169.40
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $387.36 / $387.36 / $387.36	Professional	50	$387.36	$387.36	$387.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.46 / $523.54 / $1,047.57	Professional		$132.46	$523.54	$1,047.57
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $141.66 / $141.66 / $141.66	Professional	26	$141.66	$141.66	$141.66
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,047.09 / $1,047.09 / $1,047.09	Professional	50	$1,047.09	$1,047.09	$1,047.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.96 / $101.96 / $101.96	Facility	26	$101.96	$101.96	$101.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.81 / $506.58 / $884.29	Professional		$298.81	$506.58	$884.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.01 / $107.38 / $219.54	Professional	26	$67.01	$107.38	$219.54
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $458.57 / $523.66 / $825.90	Professional	50	$458.57	$523.66	$825.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.33 / $364.98 / $706.43	Professional	TC	$216.33	$364.98	$706.43
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $74.45 / $114.93 / $116.99	Facility	26	$74.45	$114.93	$116.99
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $296.44 / $352.78 / $520.75	Professional		$296.44	$352.78	$520.75
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.45 / $99.79 / $153.00	Professional	26	$74.45	$99.79	$153.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $211.35 / $278.33 / $404.58	Professional	TC	$211.35	$278.33	$404.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $169.31 / $297.67	Professional		$93.51	$169.31	$297.67
United Facility/Professional Professional Modifier Low / Median / High Price $332.72 / $425.96 / $649.04	Professional		$332.72	$425.96	$649.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.12 / $101.11 / $156.52	Professional	26	$84.12	$101.11	$156.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.47 / $317.88 / $485.76	Professional	TC	$242.47	$317.88	$485.76