Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.31 / $109.31 / $109.32	Facility	26	$109.31	$109.31	$109.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.61 / $475.00 / $630.00	Professional		$346.61	$475.00	$630.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.16 / $128.16 / $268.08	Professional	26	$86.16	$128.16	$268.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $485.57	Professional	TC	$259.35	$335.00	$485.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.45 / $71.17 / $108.85	Professional	26	$65.45	$71.17	$108.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.50 / $510.44 / $612.53	Professional		$125.50	$510.44	$612.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.22 / $134.22 / $134.22	Professional	26	$134.22	$134.22	$134.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $368.52 / $600.00 / $985.09	Professional		$368.52	$600.00	$985.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.88 / $103.49 / $210.00	Professional	26	$63.88	$103.49	$210.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $268.52 / $466.73 / $763.31	Professional	TC	$268.52	$466.73	$763.31
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $70.01 / $109.31 / $109.32	Facility	26	$70.01	$109.31	$109.32
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $368.35 / $431.47 / $647.21	Professional		$368.35	$431.47	$647.21
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.01 / $109.32 / $183.90	Professional	26	$70.01	$109.32	$183.90
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $273.74 / $337.88 / $511.81	Professional	TC	$273.74	$337.88	$511.81
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 $370.07 / $476.01 / $687.18	Professional		$370.07	$476.01	$687.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.67 / $94.05 / $149.75	Professional	26	$79.67	$94.05	$149.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.02 / $364.49 / $619.77	Professional	TC	$281.02	$364.49	$619.77