Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.58 / $30.00 / $36.01	Facility	26	$28.58	$30.00	$36.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.35 / $180.90 / $264.31	Professional		$126.35	$180.90	$264.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $24.86 / $36.58	Professional	26	$18.76	$24.86	$36.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.86 / $151.46 / $237.21	Professional	TC	$103.86	$151.46	$237.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $18.84 / $35.21	Professional	26	$16.89	$18.84	$35.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $165.62 / $247.40	Professional		$35.72	$165.62	$247.40
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.75 / $36.75 / $36.75	Professional	26	$36.75	$36.75	$36.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.75 / $162.69 / $344.87	Professional		$116.75	$162.69	$344.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.22 / $28.22 / $65.75	Professional	26	$21.22	$28.22	$65.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.63 / $134.03 / $291.39	Professional	TC	$93.63	$134.03	$291.39
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $20.57 / $26.20 / $36.01	Facility	26	$20.57	$26.20	$36.01
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $126.58 / $173.35 / $226.54	Professional		$126.58	$173.35	$226.54
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $20.57 / $25.05 / $37.54	Professional	26	$20.57	$25.05	$37.54
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $105.93 / $152.78 / $199.17	Professional	TC	$105.93	$152.78	$199.17
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 $131.37 / $160.69 / $224.17	Professional		$131.37	$160.69	$224.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.85 / $25.98 / $41.86	Professional	26	$20.85	$25.98	$41.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.58 / $133.08 / $191.85	Professional	TC	$102.58	$133.08	$191.85