Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.17 / $62.17 / $65.27	Facility	26	$62.17	$62.17	$65.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.92 / $239.02 / $321.80	Professional		$177.92	$239.02	$321.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.50 / $55.49 / $79.41	Professional	26	$46.50	$55.49	$79.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.41 / $176.84 / $266.72	Professional	TC	$131.41	$176.84	$266.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $66.59 / $66.59	Professional	26	$40.09	$66.59	$66.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.18 / $250.37 / $362.74	Professional		$77.18	$250.37	$362.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.55 / $82.55 / $82.55	Professional	26	$82.55	$82.55	$82.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.80 / $59.80 / $59.80	Facility	26	$59.80	$59.80	$59.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.90 / $310.27 / $606.30	Professional		$203.90	$310.27	$606.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.24 / $65.26 / $130.00	Professional	26	$41.24	$65.26	$130.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.34 / $224.28 / $434.55	Professional	TC	$148.34	$224.28	$434.55
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $44.29 / $62.17 / $63.28	Facility	26	$44.29	$62.17	$63.28
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $182.09 / $218.08 / $332.96	Professional		$182.09	$218.08	$332.96
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $44.29 / $55.49 / $87.07	Professional	26	$44.29	$55.49	$87.07
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $137.80 / $166.97 / $265.26	Professional	TC	$137.80	$166.97	$265.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $172.47 / $242.63	Professional		$35.58	$172.47	$242.63
United Facility/Professional Professional Modifier Low / Median / High Price $205.85 / $246.05 / $368.31	Professional		$205.85	$246.05	$368.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.87 / $60.37 / $91.53	Professional	26	$50.87	$60.37	$91.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $155.83 / $183.82 / $276.77	Professional	TC	$155.83	$183.82	$276.77