Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $178.75 / $178.75 / $187.68	Facility	26	$178.75	$178.75	$187.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.47 / $410.23 / $732.91	Professional		$317.47	$410.23	$732.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $140.30 / $182.28	Professional	26	$131.81	$140.30	$182.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $185.65 / $269.19 / $338.02	Professional	TC	$185.65	$269.19	$338.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $450.53 / $450.53 / $450.53	Professional		$450.53	$450.53	$450.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.09 / $658.53 / $771.04	Professional		$218.09	$658.53	$771.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $245.53 / $245.53 / $245.53	Professional	26	$245.53	$245.53	$245.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $319.89 / $513.29 / $922.28	Professional		$319.89	$513.29	$922.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.34 / $227.38 / $339.53	Professional	26	$129.34	$227.38	$339.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $187.66 / $288.70 / $656.73	Professional	TC	$187.66	$288.70	$656.73
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $113.15 / $113.15 / $178.75	Facility	26	$113.15	$113.15	$178.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $263.42 / $365.09 / $604.20	Professional		$263.42	$365.09	$604.20
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $113.15 / $137.41 / $194.41	Professional	26	$113.15	$137.41	$194.41
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $150.27 / $201.34 / $410.78	Professional	TC	$150.27	$201.34	$410.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $154.61 / $292.96 / $508.70	Professional		$154.61	$292.96	$508.70
United Facility/Professional Professional Modifier Low / Median / High Price $319.37 / $430.15 / $563.04	Professional		$319.37	$430.15	$563.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $137.59 / $174.89 / $218.85	Professional	26	$137.59	$174.89	$218.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.78 / $260.57 / $331.65	Professional	TC	$181.78	$260.57	$331.65