Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.90 / $169.82 / $578.21	Professional		$109.90	$169.82	$578.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.72 / $50.88 / $92.87	Professional	26	$31.72	$50.88	$92.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.18 / $118.94 / $414.41	Professional	TC	$78.18	$118.94	$414.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.69 / $211.47 / $247.59	Professional		$82.69	$211.47	$247.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.51 / $65.51 / $65.51	Professional	26	$65.51	$65.51	$65.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.68 / $118.11 / $233.15	Professional		$62.68	$118.11	$233.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.59 / $52.73 / $97.45	Professional	26	$18.59	$52.73	$97.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.49 / $115.54 / $167.24	Professional	TC	$41.49	$115.54	$167.24
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $143.76 / $213.97 / $293.20	Professional		$143.76	$213.97	$293.20
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.78 / $59.89 / $92.63	Professional	26	$45.78	$59.89	$92.63
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $103.81 / $154.09 / $211.44	Professional	TC	$103.81	$154.09	$211.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.47 / $113.06 / $183.95	Professional		$34.47	$113.06	$183.95
United Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $174.06 / $247.24	Professional		$80.33	$174.06	$247.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.99 / $55.07 / $70.95	Professional	26	$25.99	$55.07	$70.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.34 / $98.41 / $177.06	Professional	TC	$54.34	$98.41	$177.06