Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.26 / $27.26 / $34.36	Facility	26	$27.26	$27.26	$34.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.70 / $139.28 / $220.82	Professional		$113.70	$139.28	$220.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $24.14 / $40.28	Professional	26	$14.49	$24.14	$40.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.01 / $112.01 / $187.00	Professional	TC	$92.01	$112.01	$187.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $72.20 / $72.20	Professional		$72.20	$72.20	$72.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.75 / $21.82 / $32.72	Professional	26	$16.75	$21.82	$32.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $173.15 / $218.71	Professional		$33.86	$173.15	$218.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.79 / $36.22 / $36.22	Professional	26	$30.79	$36.22	$36.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.71 / $158.71 / $158.71	Professional	TC	$158.71	$158.71	$158.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.70 / $26.70 / $26.70	Facility	26	$26.70	$26.70	$26.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.03 / $164.63 / $345.44	Professional		$118.03	$164.63	$345.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.03 / $25.63 / $65.43	Professional	26	$17.03	$25.63	$65.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.21 / $139.02 / $289.45	Professional	TC	$96.21	$139.02	$289.45
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $15.48 / $27.26 / $34.36	Facility	26	$15.48	$27.26	$34.36
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $118.43 / $159.66 / $213.39	Professional		$118.43	$159.66	$213.39
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $15.48 / $25.07 / $40.28	Professional	26	$15.48	$25.07	$40.28
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $101.17 / $134.41 / $179.81	Professional	TC	$101.17	$134.41	$179.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $111.59 / $167.33	Professional		$36.43	$111.59	$167.33
United Facility/Professional Professional Modifier Low / Median / High Price $131.37 / $165.29 / $221.94	Professional		$131.37	$165.29	$221.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.66 / $22.97 / $37.89	Professional	26	$15.66	$22.97	$37.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.84 / $143.44 / $192.47	Professional	TC	$105.84	$143.44	$192.47