Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.01 / $347.33 / $841.70	Facility		$118.01	$347.33	$841.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.30 / $18.30 / $19.21	Facility	26	$18.30	$18.30	$19.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $104.70 / $185.93	Professional		$81.59	$104.70	$185.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.19 / $16.54 / $68.83	Professional	26	$14.19	$16.54	$68.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.40 / $85.03 / $162.19	Professional	TC	$67.40	$85.03	$162.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.84 / $19.62 / $19.62	Professional	26	$11.84	$19.62	$19.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $143.91 / $204.69 / $355.75	Facility		$143.91	$204.69	$355.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.00 / $137.47 / $204.38	Professional		$24.00	$137.47	$204.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.83 / $24.50 / $24.50	Professional	26	$20.83	$24.50	$24.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.32 / $116.32 / $116.32	Facility		$116.32	$116.32	$116.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $17.75	Facility	26	$17.75	$17.75	$17.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.58 / $105.72 / $217.00	Professional		$73.58	$105.72	$217.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $19.13 / $37.81	Professional	26	$11.86	$19.13	$37.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.37 / $86.23 / $184.40	Professional	TC	$60.37	$86.23	$184.40
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $118.01 / $688.23 / $841.70	Facility		$118.01	$688.23	$841.70
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.63 / $18.30 / $19.21	Facility	26	$12.63	$18.30	$19.21
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $70.53 / $107.53 / $185.93	Professional		$70.53	$107.53	$185.93
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.63 / $17.19 / $49.58	Professional	26	$12.63	$17.19	$49.58
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $57.90 / $86.74 / $159.60	Professional	TC	$57.90	$86.74	$159.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.52 / $97.84 / $133.91	Professional		$78.52	$97.84	$133.91
United Facility/Professional Facility Modifier Low / Median / High Price $83.90 / $189.46 / $230.13	Facility		$83.90	$189.46	$230.13
United Facility/Professional Professional Modifier Low / Median / High Price $82.85 / $93.95 / $146.68	Professional		$82.85	$93.95	$146.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.68 / $17.64 / $27.22	Professional	26	$14.68	$17.64	$27.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.06 / $77.53 / $106.26	Professional	TC	$67.06	$77.53	$106.26