Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.09 / $41.57 / $46.47	Facility	26	$31.09	$41.57	$46.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $121.48 / $170.50	Professional		$86.29	$121.48	$170.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.42 / $31.09 / $138.33	Professional	26	$23.42	$31.09	$138.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.86 / $90.38 / $126.87	Professional	TC	$62.86	$90.38	$126.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.94 / $23.20 / $41.44	Professional	26	$15.94	$23.20	$41.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.36 / $183.08 / $214.36	Professional		$46.36	$183.08	$214.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.14 / $52.19 / $52.19	Professional	26	$39.14	$52.19	$52.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.44 / $115.44 / $115.44	Professional	TC	$115.44	$115.44	$115.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.06 / $65.34 / $218.81	Professional		$44.06	$65.34	$218.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $16.32 / $61.13	Professional	26	$13.07	$16.32	$61.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.00 / $45.38 / $157.68	Professional	TC	$31.00	$45.38	$157.68
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $20.29 / $31.09 / $43.64	Facility	26	$20.29	$31.09	$43.64
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $89.38 / $115.66 / $204.61	Professional		$89.38	$115.66	$204.61
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $20.29 / $31.87 / $136.50	Professional	26	$20.29	$31.87	$136.50
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $51.97 / $85.25 / $151.04	Professional	TC	$51.97	$85.25	$151.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.43 / $106.43 / $146.20	Professional		$34.43	$106.43	$146.20
United Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $97.31 / $182.51	Professional		$61.54	$97.31	$182.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $26.61 / $45.76	Professional	26	$17.23	$26.61	$45.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.30 / $68.97 / $131.65	Professional	TC	$44.30	$68.97	$131.65