Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.85 / $108.85 / $108.86	Facility	26	$108.85	$108.85	$108.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.62 / $243.78 / $386.25	Professional		$146.62	$243.78	$386.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.82 / $83.18 / $138.49	Professional	26	$56.82	$83.18	$138.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.43 / $134.04 / $250.49	Professional	TC	$63.43	$134.04	$250.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.13 / $151.13 / $151.13	Professional		$151.13	$151.13	$151.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.84 / $79.16 / $79.16	Professional	26	$73.84	$79.16	$79.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.57 / $242.52 / $278.89	Professional		$106.57	$242.52	$278.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $145.40 / $145.40 / $145.40	Professional	26	$145.40	$145.40	$145.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $105.26 / $105.26	Facility	26	$105.26	$105.26	$105.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.85 / $280.42 / $574.34	Professional		$140.85	$280.42	$574.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.25 / $99.47 / $227.12	Professional	26	$61.25	$99.47	$227.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.57 / $144.83 / $484.80	Professional	TC	$62.57	$144.83	$484.80
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $52.03 / $108.85 / $110.81	Facility	26	$52.03	$108.85	$110.81
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $174.65 / $194.22 / $349.67	Professional		$174.65	$194.22	$349.67
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $52.03 / $86.30 / $138.49	Professional	26	$52.03	$86.30	$138.49
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $75.87 / $141.66 / $232.83	Professional	TC	$75.87	$141.66	$232.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $102.86 / $185.27	Professional		$59.64	$102.86	$185.27
United Facility/Professional Professional Modifier Low / Median / High Price $169.37 / $237.14 / $452.02	Professional		$169.37	$237.14	$452.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.64 / $76.98 / $117.36	Professional	26	$61.64	$76.98	$117.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.45 / $148.44 / $364.15	Professional	TC	$76.45	$148.44	$364.15