Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.21 / $120.21 / $151.46	Facility	26	$120.21	$120.21	$151.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.74 / $351.89 / $590.40	Professional		$293.74	$351.89	$590.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.57 / $102.65 / $163.50	Professional	26	$89.57	$102.65	$163.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.15 / $251.86 / $426.90	Professional	TC	$204.15	$251.86	$426.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $338.48 / $338.48 / $338.48	Professional		$338.48	$338.48	$338.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $99.18 / $137.16 / $137.16	Professional	26	$99.18	$137.16	$137.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.38 / $417.90 / $626.86	Professional		$154.38	$417.90	$626.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $165.11 / $165.11 / $165.11	Professional	26	$165.11	$165.11	$165.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.43 / $521.60 / $750.65	Professional		$318.43	$521.60	$750.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.71 / $154.27 / $228.90	Professional	26	$87.71	$154.27	$228.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $205.94 / $294.39 / $521.75	Professional	TC	$205.94	$294.39	$521.75
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $76.34 / $120.21 / $122.37	Facility	26	$76.34	$120.21	$122.37
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $241.43 / $314.17 / $492.54	Professional		$241.43	$314.17	$492.54
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $76.34 / $95.98 / $151.46	Professional	26	$76.34	$95.98	$151.46
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $165.07 / $218.19 / $352.59	Professional	TC	$165.07	$218.19	$352.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $227.34 / $367.69	Professional		$93.51	$227.34	$367.69
United Facility/Professional Professional Modifier Low / Median / High Price $291.81 / $367.61 / $464.14	Professional		$291.81	$367.61	$464.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.76 / $116.71 / $165.36	Professional	26	$92.76	$116.71	$165.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $201.54 / $248.37 / $316.61	Professional	TC	$201.54	$248.37	$316.61