Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.12 / $66.12 / $66.12	Facility	26	$66.12	$66.12	$66.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $372.93 / $436.64 / $583.00	Professional		$372.93	$436.64	$583.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.55 / $65.44 / $75.98	Professional	26	$56.55	$65.44	$75.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $183.90 / $207.70 / $281.98	Professional	52	$183.90	$207.70	$281.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $318.04 / $367.88 / $517.55	Professional	TC	$318.04	$367.88	$517.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.93 / $436.59 / $566.73	Professional		$64.93	$436.59	$566.73
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.66 / $72.66 / $72.66	Professional	26	$72.66	$72.66	$72.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $378.06 / $681.73 / $1,098.86	Professional		$378.06	$681.73	$1,098.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.20 / $103.84 / $149.37	Professional	26	$50.20	$103.84	$149.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $331.87 / $592.27 / $949.50	Professional	TC	$331.87	$592.27	$949.50
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $60.80 / $60.80 / $66.12	Facility	26	$60.80	$60.80	$66.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $389.86 / $482.94 / $613.11	Professional		$389.86	$482.94	$613.11
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $59.35 / $64.76 / $86.42	Professional	26	$59.35	$64.76	$86.42
Health Alliance Plan Facility/Professional Professional Modifier 52 Low / Median / High Price $188.66 / $207.70 / $281.98	Professional	52	$188.66	$207.70	$281.98
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $331.83 / $422.14 / $540.64	Professional	TC	$331.83	$422.14	$540.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.07 / $365.58 / $545.43	Professional		$36.07	$365.58	$545.43
United Facility/Professional Professional Modifier Low / Median / High Price $414.67 / $513.77 / $702.00	Professional		$414.67	$513.77	$702.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.97 / $77.34 / $104.67	Professional	26	$61.97	$77.34	$104.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $351.51 / $449.70 / $619.69	Professional	TC	$351.51	$449.70	$619.69