Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.65 / $42.65 / $53.75	Facility	26	$42.65	$42.65	$53.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.36 / $168.37 / $262.38	Professional		$125.36	$168.37	$262.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.89 / $42.65 / $106.83	Professional	26	$31.89	$42.65	$106.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.47 / $125.72 / $207.79	Professional	TC	$93.47	$125.72	$207.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.75 / $30.17 / $35.49	Professional	26	$27.75	$30.17	$35.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.29 / $197.80 / $242.61	Professional		$53.29	$197.80	$242.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.99 / $56.99 / $56.99	Professional	26	$56.99	$56.99	$56.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.92 / $40.92 / $40.92	Facility	26	$40.92	$40.92	$40.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.31 / $181.10 / $407.21	Professional		$119.31	$181.10	$407.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.79 / $43.07 / $104.59	Professional	26	$28.79	$43.07	$104.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.90 / $132.01 / $322.88	Professional	TC	$86.90	$132.01	$322.88
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $29.38 / $42.65 / $53.75	Facility	26	$29.38	$42.65	$53.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $122.47 / $159.21 / $240.60	Professional		$122.47	$159.21	$240.60
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.38 / $40.11 / $94.71	Professional	26	$29.38	$40.11	$94.71
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $93.09 / $121.01 / $185.64	Professional	TC	$93.09	$121.01	$185.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.07 / $120.78 / $199.65	Professional		$36.07	$120.78	$199.65
United Facility/Professional Professional Modifier Low / Median / High Price $127.76 / $159.16 / $217.14	Professional		$127.76	$159.16	$217.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.15 / $40.35 / $55.47	Professional	26	$33.15	$40.35	$55.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.19 / $119.82 / $160.97	Professional	TC	$92.19	$119.82	$160.97