Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.53 / $33.53 / $33.53	Facility	26	$33.53	$33.53	$33.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $61.49 / $93.82	Professional		$41.03	$61.49	$93.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.54 / $28.51 / $38.54	Professional	26	$23.54	$28.51	$38.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.67 / $31.03 / $48.47	Professional	TC	$16.67	$31.03	$48.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.44 / $53.61 / $57.13	Professional		$47.44	$53.61	$57.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.85 / $60.96 / $100.80	Professional		$36.85	$60.96	$100.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.50 / $33.50 / $39.40	Professional	26	$33.50	$33.50	$39.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.95 / $72.53 / $253.41	Professional		$50.95	$72.53	$253.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.76 / $38.04 / $105.94	Professional	26	$27.76	$38.04	$105.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $32.99 / $147.46	Professional	TC	$20.07	$32.99	$147.46
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $34.13	Facility	26	$25.12	$25.12	$34.13
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $41.08 / $59.04 / $93.82	Professional		$41.08	$59.04	$93.82
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.66 / $28.81 / $41.86	Professional	26	$24.66	$28.81	$41.86
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $15.96 / $30.14 / $49.70	Professional	TC	$15.96	$30.14	$49.70
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 $43.65 / $52.12 / $72.73	Professional		$43.65	$52.12	$72.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $30.24 / $42.85	Professional	26	$24.78	$30.24	$42.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.68 / $21.92 / $35.56	Professional	TC	$16.68	$21.92	$35.56