Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.77 / $78.77 / $78.77	Facility	26	$78.77	$78.77	$78.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.57 / $275.08 / $518.11	Professional		$215.57	$275.08	$518.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.95 / $65.45 / $78.77	Professional	26	$52.95	$65.45	$78.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.52 / $196.32 / $455.81	Professional	TC	$153.52	$196.32	$455.81
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $41.84 / $41.84 / $41.84	Professional	52	$41.84	$41.84	$41.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.13 / $316.63 / $362.25	Professional		$91.13	$316.63	$362.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.47 / $97.47 / $97.47	Professional	26	$97.47	$97.47	$97.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.52 / $390.76 / $782.32	Professional		$200.52	$390.76	$782.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.97 / $82.88 / $134.52	Professional	26	$43.97	$82.88	$134.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.71 / $284.32 / $401.81	Professional	TC	$146.71	$284.32	$401.81
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $47.36 / $47.36 / $78.77	Facility	26	$47.36	$47.36	$78.77
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $235.08 / $281.77 / $518.11	Professional		$235.08	$281.77	$518.11
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $47.36 / $62.28 / $92.85	Professional	26	$47.36	$62.28	$92.85
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $166.65 / $234.41 / $455.81	Professional	TC	$166.65	$234.41	$455.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.47 / $157.81 / $222.63	Professional		$61.47	$157.81	$222.63
United Facility/Professional Professional Modifier Low / Median / High Price $216.01 / $350.94 / $704.79	Professional		$216.01	$350.94	$704.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.07 / $64.05 / $90.89	Professional	26	$55.07	$64.05	$90.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.12 / $247.37 / $633.84	Professional	TC	$157.12	$247.37	$633.84