Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.24 / $145.11 / $247.99	Facility		$132.24	$145.11	$247.99
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 $109.16 / $129.78 / $196.78	Professional		$109.16	$129.78	$196.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.37 / $22.95 / $35.07	Professional	26	$20.37	$22.95	$35.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.20 / $104.97 / $161.71	Professional	TC	$86.20	$104.97	$161.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.26 / $96.26 / $141.57	Professional		$96.26	$96.26	$141.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $16.89 / $31.68	Professional	26	$16.89	$16.89	$31.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $210.83 / $400.73 / $819.08	Facility		$210.83	$400.73	$819.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $173.80 / $217.25	Professional		$35.72	$173.80	$217.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.24 / $36.75 / $36.75	Professional	26	$31.24	$36.75	$36.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.97 / $131.97 / $131.97	Facility		$131.97	$131.97	$131.97
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 $109.47 / $156.01 / $332.45	Professional		$109.47	$156.01	$332.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.96 / $27.89 / $65.75	Professional	26	$21.96	$27.89	$65.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.02 / $130.24 / $272.11	Professional	TC	$89.02	$130.24	$272.11
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $132.24 / $164.90 / $247.99	Facility		$132.24	$164.90	$247.99
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $21.95 / $27.26 / $34.36	Facility	26	$21.95	$27.26	$34.36
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $116.03 / $164.90 / $214.37	Professional		$116.03	$164.90	$214.37
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $21.79 / $24.71 / $38.61	Professional	26	$21.79	$24.71	$38.61
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $95.53 / $131.33 / $175.65	Professional	TC	$95.53	$131.33	$175.65
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 Facility Modifier Low / Median / High Price $20.32 / $107.27 / $132.51	Facility		$20.32	$107.27	$132.51
United Facility/Professional Professional Modifier Low / Median / High Price $123.12 / $158.94 / $210.89	Professional		$123.12	$158.94	$210.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.66 / $26.35 / $41.04	Professional	26	$21.66	$26.35	$41.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.92 / $137.97 / $205.40	Professional	TC	$97.92	$137.97	$205.40