Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.85 / $24.85 / $24.85	Facility	26	$24.85	$24.85	$24.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.39 / $58.80 / $134.22	Professional		$33.39	$58.80	$134.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $26.09 / $37.24	Professional	26	$18.05	$26.09	$37.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.27 / $20.68 / $97.42	Professional	TC	$14.27	$20.68	$97.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.69 / $37.69 / $37.69	Professional		$37.69	$37.69	$37.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.40 / $61.80 / $88.05	Professional		$26.40	$61.80	$88.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $33.54 / $33.54	Professional	26	$33.54	$33.54	$33.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.05 / $24.05 / $24.05	Facility	26	$24.05	$24.05	$24.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.68 / $61.43 / $146.08	Professional		$26.68	$61.43	$146.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.74 / $32.39 / $59.68	Professional	26	$14.74	$32.39	$59.68
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $104.12 / $104.12 / $104.12	Professional	50	$104.12	$104.12	$104.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.94 / $26.26 / $104.16	Professional	TC	$11.94	$26.26	$104.16
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $24.85 / $33.94 / $33.94	Facility	26	$24.85	$33.94	$33.94
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $37.69 / $86.01 / $136.06	Professional		$37.69	$86.01	$136.06
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.19 / $33.40 / $41.06	Professional	26	$22.19	$33.40	$41.06
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.05 / $32.97 / $97.02	Professional	TC	$18.05	$32.97	$97.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $32.91 / $46.52	Professional		$26.31	$32.91	$46.52
United Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $48.69 / $148.13	Professional		$37.07	$48.69	$148.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.06 / $27.46 / $43.34	Professional	26	$22.06	$27.46	$43.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.41 / $23.01 / $116.49	Professional	TC	$15.41	$23.01	$116.49