Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.10 / $27.10 / $27.10	Facility	26	$27.10	$27.10	$27.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.88 / $159.49 / $159.49	Professional		$93.88	$159.49	$159.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $132.38 / $132.38	Professional	TC	$78.06	$132.38	$132.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $207.65 / $249.18	Professional		$34.36	$207.65	$249.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $26.26 / $26.26	Facility	26	$26.26	$26.26	$26.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.11 / $145.11 / $296.95	Professional		$96.11	$145.11	$296.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.64 / $120.00 / $245.81	Professional	TC	$76.64	$120.00	$245.81
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $19.39 / $19.39 / $27.10	Facility	26	$19.39	$19.39	$27.10
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $91.05 / $134.21 / $198.06	Professional		$91.05	$134.21	$198.06
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $71.65 / $111.46 / $170.08	Professional	TC	$71.65	$111.46	$170.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $84.71 / $115.34 / $165.06	Professional		$84.71	$115.34	$165.06
United Facility/Professional Professional Modifier Low / Median / High Price $104.46 / $122.89 / $178.12	Professional		$104.46	$122.89	$178.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.67 / $98.43 / $142.59	Professional	TC	$81.67	$98.43	$142.59