Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.14 / $41.14 / $51.83	Facility	26	$41.14	$41.14	$51.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.29 / $69.30 / $109.75	Professional		$50.29	$69.30	$109.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.14 / $35.75 / $50.60	Professional	26	$29.14	$35.75	$50.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $33.03 / $50.06	Professional	TC	$18.03	$33.03	$50.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.54 / $64.54 / $64.54	Professional		$64.54	$64.54	$64.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.22 / $40.72 / $74.34	Professional	26	$39.22	$40.72	$74.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.53 / $61.86 / $110.23	Professional		$43.53	$61.86	$110.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.65 / $41.65 / $49.00	Professional	26	$41.65	$41.65	$49.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.99 / $56.99 / $56.99	Professional	TC	$56.99	$56.99	$56.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.39 / $84.42 / $286.33	Professional		$58.39	$84.42	$286.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.13 / $47.11 / $131.71	Professional	26	$34.13	$47.11	$131.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.81 / $34.27 / $154.62	Professional	TC	$21.81	$34.27	$154.62
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $32.15 / $41.14 / $43.19	Facility	26	$32.15	$41.14	$43.19
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $49.76 / $69.61 / $109.80	Professional		$49.76	$69.61	$109.80
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.51 / $36.13 / $54.30	Professional	26	$30.51	$36.13	$54.30
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $17.60 / $33.20 / $53.73	Professional	TC	$17.60	$33.20	$53.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $45.18 / $79.93	Professional		$28.18	$45.18	$79.93
United Facility/Professional Professional Modifier Low / Median / High Price $51.75 / $61.57 / $83.56	Professional		$51.75	$61.57	$83.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.54 / $37.52 / $53.28	Professional	26	$31.54	$37.52	$53.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.38 / $24.12 / $36.34	Professional	TC	$18.38	$24.12	$36.34