Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.83 / $53.83 / $67.81	Facility	26	$53.83	$53.83	$67.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.58 / $240.06 / $288.07	Professional		$194.58	$240.06	$288.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.77 / $53.82 / $67.81	Professional	26	$42.77	$53.82	$67.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $150.57 / $186.24 / $230.90	Professional	TC	$150.57	$186.24	$230.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $249.81 / $249.81 / $249.81	Professional		$249.81	$249.81	$249.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.87 / $289.22 / $342.87	Professional		$63.87	$289.22	$342.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.90 / $71.90 / $71.90	Professional	26	$71.90	$71.90	$71.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.49 / $365.33 / $505.69	Professional		$188.49	$365.33	$505.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.15 / $53.69 / $99.51	Professional	26	$32.15	$53.69	$99.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.06 / $285.43 / $427.34	Professional	TC	$151.06	$285.43	$427.34
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $37.84 / $37.84 / $56.52	Facility	26	$37.84	$37.84	$56.52
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $194.32 / $240.06 / $340.82	Professional		$194.32	$240.06	$340.82
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $37.84 / $50.58 / $69.16	Professional	26	$37.84	$50.58	$69.16
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $156.47 / $186.24 / $279.36	Professional	TC	$156.47	$186.24	$279.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.83 / $169.62 / $227.84	Professional		$33.83	$169.62	$227.84
United Facility/Professional Professional Modifier Low / Median / High Price $212.72 / $255.69 / $351.79	Professional		$212.72	$255.69	$351.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.60 / $53.09 / $68.31	Professional	26	$43.60	$53.09	$68.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $166.68 / $201.69 / $289.20	Professional	TC	$166.68	$201.69	$289.20