Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.76 / $65.76 / $69.05	Facility	26	$65.76	$65.76	$69.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.22 / $192.97 / $294.18	Professional		$162.22	$192.97	$294.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $61.62 / $173.03	Professional	26	$51.54	$61.62	$173.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.68 / $131.78 / $208.15	Professional	TC	$110.68	$131.78	$208.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.82 / $54.79 / $109.71	Professional	26	$52.82	$54.79	$109.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.59 / $215.72 / $280.68	Professional		$111.59	$215.72	$280.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.41 / $88.41 / $88.41	Professional	26	$88.41	$88.41	$88.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.13 / $273.73 / $377.50	Professional		$159.13	$273.73	$377.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.00 / $79.52 / $121.53	Professional	26	$41.00	$79.52	$121.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.06 / $186.58 / $263.70	Professional	TC	$103.06	$186.58	$263.70
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $65.76 / $66.95	Facility	26	$45.71	$65.76	$66.95
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $137.63 / $190.27 / $290.49	Professional		$137.63	$190.27	$290.49
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $62.20 / $124.48	Professional	26	$45.71	$62.20	$124.48
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $91.91 / $128.06 / $202.76	Professional	TC	$91.91	$128.06	$202.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $138.76 / $189.67	Professional		$34.36	$138.76	$189.67
United Facility/Professional Professional Modifier Low / Median / High Price $161.53 / $195.75 / $272.45	Professional		$161.53	$195.75	$272.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.86 / $63.96 / $82.49	Professional	26	$53.86	$63.96	$82.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.99 / $128.24 / $187.56	Professional	TC	$103.99	$128.24	$187.56