Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.46 / $58.46 / $58.46	Facility	26	$58.46	$58.46	$58.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.24 / $161.27 / $233.94	Professional		$138.24	$161.27	$233.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.14 / $51.30 / $73.65	Professional	26	$42.14	$51.30	$73.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.92 / $103.82 / $165.99	Professional	TC	$89.92	$103.82	$165.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $64.09 / $85.46	Professional	26	$34.79	$64.09	$85.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $146.22 / $237.83	Professional		$66.73	$146.22	$237.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.66 / $71.37 / $71.37	Professional	26	$60.66	$71.37	$71.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.84 / $51.84 / $51.84	Facility	26	$51.84	$51.84	$51.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.41 / $213.05 / $361.09	Professional		$121.41	$213.05	$361.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.36 / $55.61 / $113.20	Professional	26	$34.36	$55.61	$113.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.39 / $147.26 / $245.48	Professional	TC	$79.39	$147.26	$245.48
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $37.84 / $58.46 / $58.46	Facility	26	$37.84	$58.46	$58.46
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $141.79 / $161.27 / $241.21	Professional		$141.79	$161.27	$241.21
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $37.84 / $50.32 / $81.14	Professional	26	$37.84	$50.32	$81.14
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $93.45 / $103.95 / $166.00	Professional	TC	$93.45	$103.95	$166.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $108.90 / $159.69	Professional		$34.95	$108.90	$159.69
United Facility/Professional Professional Modifier Low / Median / High Price $137.59 / $173.09 / $257.85	Professional		$137.59	$173.09	$257.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.31 / $50.88 / $75.81	Professional	26	$43.31	$50.88	$75.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.19 / $115.95 / $172.87	Professional	TC	$89.19	$115.95	$172.87