Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.80 / $109.80 / $109.80	Facility	26	$109.80	$109.80	$109.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $343.62 / $429.14 / $613.42	Professional		$343.62	$429.14	$613.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.57 / $109.80 / $145.65	Professional	26	$85.57	$109.80	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.08 / $319.35 / $484.30	Professional	TC	$257.08	$319.35	$484.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $189.73 / $545.91 / $1,225.04	Professional		$189.73	$545.91	$1,225.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $135.28 / $135.28 / $135.28	Professional	26	$135.28	$135.28	$135.28
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,091.83 / $1,091.83 / $1,091.83	Professional	50	$1,091.83	$1,091.83	$1,091.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.37 / $97.37 / $97.37	Facility	26	$97.37	$97.37	$97.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $368.46 / $601.02 / $988.61	Professional		$368.46	$601.02	$988.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.06 / $104.92 / $210.57	Professional	26	$64.06	$104.92	$210.57
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $507.23 / $580.67 / $988.61	Professional	50	$507.23	$580.67	$988.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $266.64 / $462.52 / $765.19	Professional	TC	$266.64	$462.52	$765.19
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $70.80 / $70.80 / $109.80	Facility	26	$70.80	$70.80	$109.80
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $368.40 / $429.14 / $643.71	Professional		$368.40	$429.14	$643.71
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.80 / $108.07 / $151.52	Professional	26	$70.80	$108.07	$151.52
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $273.02 / $338.67 / $587.45	Professional	TC	$273.02	$338.67	$587.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.24 / $255.36 / $371.09	Professional		$93.24	$255.36	$371.09
United Facility/Professional Professional Modifier Low / Median / High Price $361.11 / $480.89 / $751.13	Professional		$361.11	$480.89	$751.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.81 / $94.06 / $138.05	Professional	26	$79.81	$94.06	$138.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $273.04 / $360.74 / $558.87	Professional	TC	$273.04	$360.74	$558.87