Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.51 / $31.51 / $31.52	Facility	26	$31.51	$31.51	$31.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.14 / $111.18 / $177.01	Professional		$87.14	$111.18	$177.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.17 / $27.03 / $70.59	Professional	26	$23.17	$27.03	$70.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.32 / $82.00 / $137.19	Professional	TC	$63.32	$82.00	$137.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $33.65 / $50.98	Professional	26	$20.23	$33.65	$50.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.84 / $140.51 / $199.67	Professional		$38.84	$140.51	$199.67
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.54 / $41.54 / $41.54	Professional	26	$41.54	$41.54	$41.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $116.64 / $116.64 / $116.64	Professional	TC	$116.64	$116.64	$116.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $30.07	Facility	26	$30.07	$30.07	$30.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.98 / $116.64 / $211.98	Professional		$78.98	$116.64	$211.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.09 / $31.98 / $65.16	Professional	26	$20.09	$31.98	$65.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.36 / $83.30 / $171.97	Professional	TC	$57.36	$83.30	$171.97
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $21.24 / $31.51 / $32.08	Facility	26	$21.24	$31.51	$32.08
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $83.11 / $111.18 / $177.01	Professional		$83.11	$111.18	$177.01
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $21.24 / $29.56 / $68.33	Professional	26	$21.24	$29.56	$68.33
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $61.86 / $82.00 / $137.00	Professional	TC	$61.86	$82.00	$137.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $76.71 / $117.12	Professional		$34.95	$76.71	$117.12
United Facility/Professional Professional Modifier Low / Median / High Price $84.82 / $100.89 / $140.69	Professional		$84.82	$100.89	$140.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.23 / $28.68 / $44.64	Professional	26	$24.23	$28.68	$44.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.71 / $73.37 / $102.31	Professional	TC	$60.71	$73.37	$102.31