Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.51 / $35.92 / $35.92	Facility	26	$28.51	$35.92	$35.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.93 / $177.46 / $384.82	Professional		$151.93	$177.46	$384.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.31 / $28.51 / $53.71	Professional	26	$22.31	$28.51	$53.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.87 / $155.77 / $338.54	Professional	TC	$129.87	$155.77	$338.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.16 / $131.16 / $131.16	Professional		$131.16	$131.16	$131.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.12 / $17.12 / $17.12	Professional	26	$17.12	$17.12	$17.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.86 / $225.44 / $296.93	Professional		$34.86	$225.44	$296.93
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.28 / $37.28 / $37.28	Professional	26	$37.28	$37.28	$37.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $216.77 / $216.77 / $216.77	Professional	TC	$216.77	$216.77	$216.77
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 $143.84 / $210.41 / $458.55	Professional		$143.84	$210.41	$458.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.28 / $29.93 / $65.75	Professional	26	$23.28	$29.93	$65.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.71 / $183.72 / $391.61	Professional	TC	$130.71	$183.72	$391.61
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $24.89 / $28.51 / $35.92	Facility	26	$24.89	$28.51	$35.92
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $165.99 / $196.66 / $317.42	Professional		$165.99	$196.66	$317.42
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $23.60 / $28.51 / $42.77	Professional	26	$23.60	$28.51	$42.77
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $143.37 / $171.77 / $255.28	Professional	TC	$143.37	$171.77	$255.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $144.78 / $215.89	Professional		$36.43	$144.78	$215.89
United Facility/Professional Professional Modifier Low / Median / High Price $166.73 / $208.78 / $291.54	Professional		$166.73	$208.78	$291.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.00 / $28.87 / $41.65	Professional	26	$24.00	$28.87	$41.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.16 / $186.58 / $257.29	Professional	TC	$141.16	$186.58	$257.29