Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.51 / $27.51 / $28.88	Facility	26	$27.51	$27.51	$28.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.90 / $248.94 / $366.19	Professional		$221.90	$248.94	$366.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.60 / $27.51 / $35.78	Professional	26	$20.60	$27.51	$35.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $201.28 / $221.43 / $330.38	Professional	TC	$201.28	$221.43	$330.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.59 / $29.59 / $32.90	Professional	26	$29.59	$29.59	$32.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $319.20 / $355.06	Professional		$34.36	$319.20	$355.06
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.75 / $36.75 / $36.75	Professional	26	$36.75	$36.75	$36.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.84 / $256.43 / $527.27	Professional		$179.84	$256.43	$527.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.47 / $33.29 / $51.19	Professional	26	$18.47	$33.29	$51.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $155.12 / $229.17 / $478.59	Professional	TC	$155.12	$229.17	$478.59
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $19.70 / $27.51 / $28.00	Facility	26	$19.70	$27.51	$28.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $184.70 / $244.12 / $342.16	Professional		$184.70	$244.12	$342.16
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.70 / $25.84 / $36.31	Professional	26	$19.70	$25.84	$36.31
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $165.00 / $220.25 / $330.38	Professional	TC	$165.00	$220.25	$330.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.19 / $202.65 / $266.48	Professional		$34.19	$202.65	$266.48
United Facility/Professional Professional Modifier Low / Median / High Price $210.43 / $253.48 / $351.29	Professional		$210.43	$253.48	$351.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.05 / $26.94 / $33.08	Professional	26	$23.05	$26.94	$33.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $203.90 / $230.01 / $316.80	Professional	TC	$203.90	$230.01	$316.80