Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.80 / $53.80 / $53.80	Facility	26	$53.80	$53.80	$53.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $61.18 / $106.48	Professional		$55.57	$61.18	$106.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $44.36 / $99.20	Professional	26	$37.99	$44.36	$99.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.92 / $21.17 / $28.80	Professional	TC	$16.92	$21.17	$28.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.49 / $44.49 / $46.35	Professional	26	$44.49	$44.49	$46.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.88 / $83.38 / $132.44	Professional		$28.88	$83.38	$132.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.03 / $74.03 / $74.03	Professional	26	$74.03	$74.03	$74.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.92 / $90.40 / $143.07	Professional		$57.92	$90.40	$143.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.72 / $64.56 / $102.33	Professional	26	$38.72	$64.56	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.53 / $25.33 / $42.19	Professional	TC	$17.53	$25.33	$42.19
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $34.14 / $34.14 / $53.80	Facility	26	$34.14	$34.14	$53.80
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $49.16 / $60.28 / $98.66	Professional		$49.16	$60.28	$98.66
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $34.14 / $44.36 / $73.12	Professional	26	$34.14	$44.36	$73.12
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $15.03 / $19.94 / $28.67	Professional	TC	$15.03	$19.94	$28.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $40.55 / $73.98	Professional		$28.18	$40.55	$73.98
United Facility/Professional Professional Modifier Low / Median / High Price $56.64 / $72.70 / $103.47	Professional		$56.64	$72.70	$103.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.53 / $52.15 / $73.64	Professional	26	$39.53	$52.15	$73.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.11 / $20.90 / $27.32	Professional	TC	$17.11	$20.90	$27.32