Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.71 / $63.71 / $80.27	Facility	26	$63.71	$63.71	$80.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $403.39 / $448.55 / $642.38	Professional		$403.39	$448.55	$642.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.34 / $63.71 / $87.49	Professional	26	$58.34	$63.71	$87.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $345.06 / $384.84 / $538.78	Professional	TC	$345.06	$384.84	$538.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $55.19 / $69.06 / $95.94	Professional	26	$55.19	$69.06	$95.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.01 / $655.34 / $786.41	Professional		$87.01	$655.34	$786.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.48 / $89.48 / $89.48	Professional	26	$89.48	$89.48	$89.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $394.85 / $742.12 / $1,164.38	Professional		$394.85	$742.12	$1,164.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.83 / $103.50 / $145.00	Professional	26	$48.83	$103.50	$145.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $346.02 / $638.62 / $1,019.38	Professional	TC	$346.02	$638.62	$1,019.38
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $57.92 / $63.71 / $80.27	Facility	26	$57.92	$63.71	$80.27
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $403.60 / $448.55 / $605.23	Professional		$403.60	$448.55	$605.23
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $57.92 / $63.71 / $87.49	Professional	26	$57.92	$63.71	$87.49
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $345.68 / $384.84 / $513.11	Professional	TC	$345.68	$384.84	$513.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $381.60 / $575.27	Professional		$35.97	$381.60	$575.27
United Facility/Professional Professional Modifier Low / Median / High Price $401.55 / $475.15 / $711.50	Professional		$401.55	$475.15	$711.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.22 / $74.15 / $114.80	Professional	26	$58.22	$74.15	$114.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $318.77 / $401.77 / $601.02	Professional	TC	$318.77	$401.77	$601.02