Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.39 / $57.39 / $57.39	Facility	26	$57.39	$57.39	$57.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.22 / $174.65 / $367.57	Professional		$137.22	$174.65	$367.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.16 / $57.39 / $125.43	Professional	26	$41.16	$57.39	$125.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.16 / $117.26 / $209.40	Professional	TC	$92.16	$117.26	$209.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.65 / $54.65 / $60.93	Professional	26	$54.65	$54.65	$60.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.74 / $153.43 / $224.33	Professional		$63.74	$153.43	$224.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.17 / $68.17 / $68.17	Professional	26	$68.17	$68.17	$68.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.06 / $49.06 / $49.06	Facility	26	$49.06	$49.06	$49.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.81 / $191.22 / $396.81	Professional		$134.81	$191.22	$396.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.72 / $60.99 / $128.61	Professional	26	$44.72	$60.99	$128.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.17 / $133.26 / $279.43	Professional	TC	$94.17	$133.26	$279.43
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $44.91 / $57.39 / $58.42	Facility	26	$44.91	$57.39	$58.42
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $128.31 / $151.71 / $259.57	Professional		$128.31	$151.71	$259.57
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $44.89 / $51.42 / $124.53	Professional	26	$44.89	$51.42	$124.53
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $83.39 / $106.58 / $173.76	Professional	TC	$83.39	$106.58	$173.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $111.53 / $167.33	Professional		$36.43	$111.53	$167.33
United Facility/Professional Professional Modifier Low / Median / High Price $135.62 / $172.34 / $280.42	Professional		$135.62	$172.34	$280.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.24 / $55.46 / $81.30	Professional	26	$45.24	$55.46	$81.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.55 / $113.29 / $192.63	Professional	TC	$89.55	$113.29	$192.63