Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.79 / $93.79 / $98.48	Facility	26	$93.79	$93.79	$98.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.85 / $484.70 / $661.59	Professional		$342.85	$484.70	$661.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.56 / $93.80 / $171.32	Professional	26	$68.56	$93.80	$171.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $274.27 / $402.42 / $549.13	Professional	TC	$274.27	$402.42	$549.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $92.96 / $92.96 / $92.96	Professional	26	$92.96	$92.96	$92.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.19 / $567.70 / $697.37	Professional		$120.19	$567.70	$697.37
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $115.57 / $115.57 / $115.57	Professional	26	$115.57	$115.57	$115.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.10 / $388.84 / $851.23	Professional		$135.10	$388.84	$851.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.22 / $102.90 / $161.27	Professional	26	$58.22	$102.90	$161.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $262.83 / $322.51 / $742.79	Professional	TC	$262.83	$322.51	$742.79
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $93.79 / $93.80 / $98.48	Facility	26	$93.79	$93.80	$98.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $61.82 / $388.06 / $638.65	Professional		$61.82	$388.06	$638.65
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $69.62 / $93.80 / $191.40	Professional	26	$69.62	$93.80	$191.40
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $280.37 / $402.42 / $603.63	Professional	TC	$280.37	$402.42	$603.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.11 / $291.11 / $441.70	Professional		$93.11	$291.11	$441.70
United Facility/Professional Professional Modifier Low / Median / High Price $349.54 / $428.36 / $579.87	Professional		$349.54	$428.36	$579.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.01 / $86.55 / $113.32	Professional	26	$70.01	$86.55	$113.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.08 / $374.88 / $458.18	Professional	TC	$275.08	$374.88	$458.18