Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.84 / $79.84 / $100.59	Facility	26	$79.84	$79.84	$100.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.09 / $193.49 / $281.69	Professional		$120.09	$193.49	$281.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.65 / $66.61 / $100.10	Professional	26	$49.65	$66.61	$100.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.20 / $110.52 / $188.44	Professional	TC	$53.20	$110.52	$188.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $116.81 / $116.81 / $116.81	Professional		$116.81	$116.81	$116.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.08 / $54.08 / $97.29	Professional	26	$54.08	$54.08	$97.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.27 / $131.47 / $234.05	Professional		$83.27	$131.47	$234.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.52 / $106.52 / $106.52	Professional	26	$106.52	$106.52	$106.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.09 / $77.09 / $77.09	Facility	26	$77.09	$77.09	$77.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.25 / $215.26 / $522.69	Professional		$111.25	$215.26	$522.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.92 / $76.93 / $167.49	Professional	26	$48.92	$76.93	$167.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.73 / $112.06 / $487.19	Professional	TC	$52.73	$112.06	$487.19
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $45.68 / $79.84 / $81.27	Facility	26	$45.68	$79.84	$81.27
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $134.55 / $157.27 / $252.65	Professional		$134.55	$157.27	$252.65
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.68 / $69.77 / $107.61	Professional	26	$45.68	$69.77	$107.61
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $62.34 / $102.88 / $177.47	Professional	TC	$62.34	$102.88	$177.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $76.74 / $117.12	Professional		$35.58	$76.74	$117.12
United Facility/Professional Professional Modifier Low / Median / High Price $122.39 / $169.76 / $398.40	Professional		$122.39	$169.76	$398.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.42 / $65.90 / $98.55	Professional	26	$53.42	$65.90	$98.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.12 / $98.03 / $335.18	Professional	TC	$66.12	$98.03	$335.18