Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.83 / $105.83 / $111.12	Facility	26	$105.83	$105.83	$111.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $311.63 / $389.06 / $522.50	Professional		$311.63	$389.06	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.78 / $105.83 / $145.65	Professional	26	$82.78	$105.83	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $227.90 / $283.23 / $373.86	Professional	TC	$227.90	$283.23	$373.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.89 / $68.30 / $104.46	Professional	26	$62.89	$68.30	$104.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.11 / $434.77 / $549.17	Professional		$133.11	$434.77	$549.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $129.41 / $129.41 / $129.41	Professional	26	$129.41	$129.41	$129.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.04 / $603.72 / $1,093.71	Professional		$353.04	$603.72	$1,093.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.26 / $100.16 / $202.97	Professional	26	$62.26	$100.16	$202.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.39 / $444.72 / $829.36	Professional	TC	$263.39	$444.72	$829.36
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $67.63 / $67.63 / $105.83	Facility	26	$67.63	$67.63	$105.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $330.38 / $456.85 / $591.39	Professional		$330.38	$456.85	$591.39
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $67.63 / $105.64 / $145.65	Professional	26	$67.63	$105.64	$145.65
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $239.35 / $373.86 / $499.00	Professional	TC	$239.35	$373.86	$499.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $226.86 / $343.71	Professional		$93.51	$226.86	$343.71
United Facility/Professional Professional Modifier Low / Median / High Price $327.76 / $514.64 / $707.64	Professional		$327.76	$514.64	$707.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.14 / $90.73 / $143.69	Professional	26	$78.14	$90.73	$143.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $266.44 / $436.81 / $617.76	Professional	TC	$266.44	$436.81	$617.76