Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.35 / $123.36 / $155.43	Facility	26	$123.35	$123.36	$155.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.75 / $465.93 / $682.63	Professional		$374.75	$465.93	$682.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.71 / $119.01 / $192.11	Professional	26	$90.71	$119.01	$192.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $268.61 / $342.56 / $440.10	Professional	TC	$268.61	$342.56	$440.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $427.61 / $427.61 / $427.61	Professional		$427.61	$427.61	$427.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $101.44 / $135.02 / $149.63	Professional	26	$101.44	$135.02	$149.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $175.58 / $571.48 / $812.11	Professional		$175.58	$571.48	$812.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $168.83 / $168.83 / $168.83	Professional	26	$168.83	$168.83	$168.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $388.46 / $621.91 / $870.10	Professional		$388.46	$621.91	$870.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.06 / $138.38 / $234.16	Professional	26	$89.06	$138.38	$234.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $296.42 / $465.22 / $694.49	Professional	TC	$296.42	$465.22	$694.49
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $100.50 / $123.35 / $129.52	Facility	26	$100.50	$123.35	$129.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $393.25 / $465.93 / $598.58	Professional		$393.25	$465.93	$598.58
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $94.01 / $117.78 / $167.46	Professional	26	$94.01	$117.78	$167.46
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $302.52 / $342.56 / $473.38	Professional	TC	$302.52	$342.56	$473.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.24 / $291.68 / $441.39	Professional		$93.24	$291.68	$441.39
United Facility/Professional Professional Modifier Low / Median / High Price $387.50 / $489.32 / $616.35	Professional		$387.50	$489.32	$616.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.87 / $122.44 / $150.90	Professional	26	$94.87	$122.44	$150.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $292.63 / $368.06 / $524.65	Professional	TC	$292.63	$368.06	$524.65