Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $146.33 / $146.33 / $184.37	Facility	26	$146.33	$146.33	$184.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.05 / $272.82 / $366.45	Professional		$208.05	$272.82	$366.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.00 / $146.33 / $173.54	Professional	26	$86.00	$146.33	$173.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.95 / $126.49 / $217.84	Professional	TC	$101.95	$126.49	$217.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.31 / $513.54 / $746.98	Professional		$169.31	$513.54	$746.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $181.08 / $181.08 / $181.08	Professional	26	$181.08	$181.08	$181.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.66 / $129.66 / $129.66	Facility	26	$129.66	$129.66	$129.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.21 / $563.83 / $1,138.19	Professional		$238.21	$563.83	$1,138.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.48 / $132.02 / $280.17	Professional	26	$85.48	$132.02	$280.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.50 / $403.36 / $880.23	Professional	TC	$157.50	$403.36	$880.23
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $91.57 / $91.57 / $184.37	Facility	26	$91.57	$91.57	$184.37
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $233.78 / $413.50 / $612.16	Professional		$233.78	$413.50	$612.16
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $91.57 / $122.19 / $187.99	Professional	26	$91.57	$122.19	$187.99
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $116.43 / $251.03 / $446.36	Professional	TC	$116.43	$251.03	$446.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.33 / $114.27 / $222.74	Professional		$83.33	$114.27	$222.74
United Facility/Professional Professional Modifier Low / Median / High Price $387.18 / $485.04 / $759.99	Professional		$387.18	$485.04	$759.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.30 / $122.70 / $184.05	Professional	26	$104.30	$122.70	$184.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $264.98 / $362.34 / $560.66	Professional	TC	$264.98	$362.34	$560.66