Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.04 / $90.04 / $94.55	Facility	26	$90.04	$90.04	$94.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.11 / $342.97 / $522.50	Professional		$202.11	$342.97	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.95 / $116.83 / $265.19	Professional	26	$67.95	$116.83	$265.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.16 / $215.34 / $368.50	Professional	TC	$134.16	$215.34	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.26 / $144.26 / $144.26	Professional		$144.26	$144.26	$144.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.17 / $100.31 / $100.31	Professional	26	$58.17	$100.31	$100.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.05 / $347.72 / $447.07	Professional		$112.05	$347.72	$447.07
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $119.84 / $119.84 / $119.84	Professional	26	$119.84	$119.84	$119.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.45 / $86.45 / $86.45	Facility	26	$86.45	$86.45	$86.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.43 / $336.15 / $604.22	Professional		$220.43	$336.15	$604.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.51 / $94.66 / $187.24	Professional	26	$59.51	$94.66	$187.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.41 / $221.48 / $421.72	Professional	TC	$144.41	$221.48	$421.72
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $63.98 / $90.04 / $94.55	Facility	26	$63.98	$90.04	$94.55
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $197.71 / $260.95 / $475.00	Professional		$197.71	$260.95	$475.00
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $63.98 / $90.05 / $262.89	Professional	26	$63.98	$90.05	$262.89
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $133.74 / $170.91 / $335.00	Professional	TC	$133.74	$170.91	$335.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.67 / $137.19 / $260.51	Professional		$93.67	$137.19	$260.51
United Facility/Professional Professional Modifier Low / Median / High Price $240.42 / $607.79 / $1,061.75	Professional		$240.42	$607.79	$1,061.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.48 / $85.26 / $125.51	Professional	26	$72.48	$85.26	$125.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $164.91 / $509.62 / $892.33	Professional	TC	$164.91	$509.62	$892.33