Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.50 / $538.99 / $877.37	Facility		$137.50	$538.99	$877.37
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.91 / $27.91 / $29.30	Facility	26	$27.91	$27.91	$29.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $128.59 / $223.86	Professional		$113.82	$128.59	$223.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $22.64 / $34.11	Professional	26	$11.77	$22.64	$34.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.35 / $109.21 / $189.87	Professional	TC	$95.35	$109.21	$189.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.27 / $123.20 / $168.04	Professional		$119.27	$123.20	$168.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.85 / $23.62 / $23.62	Professional	26	$21.85	$23.62	$23.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $182.26 / $522.74 / $1,070.63	Facility		$182.26	$522.74	$1,070.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.18 / $195.02 / $246.05	Professional		$32.18	$195.02	$246.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $36.22 / $36.22	Professional	26	$36.22	$36.22	$36.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.93 / $194.93 / $194.93	Professional	TC	$194.93	$194.93	$194.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.47 / $181.61 / $418.85	Professional		$134.47	$181.61	$418.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $25.03 / $60.60	Professional	26	$13.86	$25.03	$60.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.07 / $158.69 / $356.20	Professional	TC	$112.07	$158.69	$356.20
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $21.75 / $209.43 / $806.18	Facility		$21.75	$209.43	$806.18
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $13.11 / $23.62 / $29.30	Facility	26	$13.11	$23.62	$29.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $115.84 / $155.11 / $252.43	Professional		$115.84	$155.11	$252.43
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.05 / $23.04 / $36.13	Professional	26	$13.05	$23.04	$36.13
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $97.20 / $128.52 / $230.87	Professional	TC	$97.20	$128.52	$230.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.83 / $106.43 / $155.54	Professional		$33.83	$106.43	$155.54
United Facility/Professional Professional Modifier Low / Median / High Price $150.51 / $190.88 / $251.90	Professional		$150.51	$190.88	$251.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.01 / $25.62 / $37.78	Professional	26	$13.01	$25.62	$37.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.17 / $167.17 / $227.84	Professional	TC	$126.17	$167.17	$227.84