Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.76 / $105.76 / $105.77	Facility	26	$105.76	$105.76	$105.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.56 / $289.87 / $389.09	Professional		$231.56	$289.87	$389.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.00 / $87.67 / $238.21	Professional	26	$73.00	$87.67	$238.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.84 / $191.62 / $282.39	Professional	TC	$147.84	$191.62	$282.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.02 / $80.44 / $80.44	Professional	26	$63.02	$80.44	$80.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.50 / $270.87 / $414.71	Professional		$121.50	$270.87	$414.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $129.94 / $129.94 / $129.94	Professional	26	$129.94	$129.94	$129.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.84 / $93.84 / $93.84	Facility	26	$93.84	$93.84	$93.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.46 / $328.63 / $663.30	Professional		$234.46	$328.63	$663.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.32 / $97.17 / $202.86	Professional	26	$62.32	$97.17	$202.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $159.75 / $223.17 / $473.79	Professional	TC	$159.75	$223.17	$473.79
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $65.28 / $105.76 / $107.67	Facility	26	$65.28	$105.76	$107.67
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $244.91 / $289.87 / $412.50	Professional		$244.91	$289.87	$412.50
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $65.28 / $91.39 / $243.95	Professional	26	$65.28	$91.39	$243.95
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $161.56 / $191.62 / $285.00	Professional	TC	$161.56	$191.62	$285.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $137.18 / $260.38	Professional		$93.51	$137.18	$260.38
United Facility/Professional Professional Modifier Low / Median / High Price $239.21 / $301.63 / $445.10	Professional		$239.21	$301.63	$445.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.77 / $88.78 / $133.16	Professional	26	$75.77	$88.78	$133.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.74 / $212.58 / $301.89	Professional	TC	$159.74	$212.58	$301.89