Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.28 / $75.28 / $94.85	Facility	26	$75.28	$75.28	$94.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $308.87 / $355.61 / $469.40	Professional		$308.87	$355.61	$469.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.15 / $66.45 / $99.36	Professional	26	$57.15	$66.45	$99.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.71 / $280.33 / $370.03	Professional	TC	$251.71	$280.33	$370.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.67 / $83.67 / $124.31	Professional	26	$83.67	$83.67	$124.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $403.80 / $548.58	Professional		$89.41	$403.80	$548.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.66 / $100.66 / $100.66	Professional	26	$100.66	$100.66	$100.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.82 / $361.85 / $762.52	Professional		$279.82	$361.85	$762.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.87 / $75.12 / $140.13	Professional	26	$48.87	$75.12	$140.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $226.08 / $380.31 / $656.14	Professional	TC	$226.08	$380.31	$656.14
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $51.79 / $51.79 / $79.04	Facility	26	$51.79	$51.79	$79.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $282.11 / $328.86 / $469.52	Professional		$282.11	$328.86	$469.52
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.79 / $69.91 / $112.92	Professional	26	$51.79	$69.91	$112.92
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $230.32 / $265.67 / $420.50	Professional	TC	$230.32	$265.67	$420.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $246.06 / $341.89	Professional		$34.36	$246.06	$341.89
United Facility/Professional Professional Modifier Low / Median / High Price $317.64 / $375.08 / $547.35	Professional		$317.64	$375.08	$547.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.89 / $77.68 / $110.83	Professional	26	$64.89	$77.68	$110.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $237.12 / $293.77 / $430.72	Professional	TC	$237.12	$293.77	$430.72