Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.49 / $29.49 / $29.49	Facility	26	$29.49	$29.49	$29.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.84 / $121.55 / $154.02	Professional		$86.84	$121.55	$154.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.28 / $29.49 / $43.06	Professional	26	$24.28	$29.49	$43.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.97 / $97.12 / $123.06	Professional	TC	$58.97	$97.12	$123.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.46 / $47.47 / $47.47	Professional	26	$27.46	$47.47	$47.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.43 / $240.53 / $276.61	Professional		$55.43	$240.53	$276.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.46 / $56.46 / $56.46	Professional	26	$56.46	$56.46	$56.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.43 / $39.43 / $39.43	Facility	26	$39.43	$39.43	$39.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.33 / $206.69 / $422.20	Professional		$135.33	$206.69	$422.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $36.39 / $72.48	Professional	26	$24.55	$36.39	$72.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.46 / $171.23 / $357.59	Professional	TC	$111.46	$171.23	$357.59
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $29.49 / $30.78 / $30.78	Facility	26	$29.49	$30.78	$30.78
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $104.79 / $209.06 / $260.94	Professional		$104.79	$209.06	$260.94
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.49 / $32.61 / $51.95	Professional	26	$29.49	$32.61	$51.95
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $72.58 / $167.03 / $210.52	Professional	TC	$72.58	$167.03	$210.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $123.06 / $202.16	Professional		$36.43	$123.06	$202.16
United Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $204.09 / $278.58	Professional		$157.37	$204.09	$278.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.07 / $32.75 / $43.69	Professional	26	$27.07	$32.75	$43.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.65 / $171.65 / $230.79	Professional	TC	$131.65	$171.65	$230.79