Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.98 / $98.98 / $124.71	Facility	26	$98.98	$98.98	$124.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.95 / $432.29 / $594.63	Professional		$346.95	$432.29	$594.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.06 / $91.78 / $182.82	Professional	26	$81.06	$91.78	$182.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $265.87 / $342.78 / $497.35	Professional	TC	$265.87	$342.78	$497.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $402.91 / $427.13 / $525.85	Professional		$402.91	$427.13	$525.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.37 / $82.37 / $118.74	Professional	26	$73.37	$82.37	$118.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.99 / $628.73 / $827.28	Professional		$129.99	$628.73	$827.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $133.68 / $133.68 / $133.68	Professional	26	$133.68	$133.68	$133.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.57 / $665.40 / $1,943.74	Professional		$317.57	$665.40	$1,943.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.22 / $133.65 / $358.25	Professional	26	$73.22	$133.65	$358.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $230.60 / $525.97 / $1,585.49	Professional	TC	$230.60	$525.97	$1,585.49
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $84.85 / $98.98 / $124.71	Facility	26	$84.85	$98.98	$124.71
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $365.98 / $480.08 / $640.17	Professional		$365.98	$480.08	$640.17
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.31 / $98.98 / $159.00	Professional	26	$81.31	$98.98	$159.00
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $284.67 / $381.60 / $522.72	Professional	TC	$284.67	$381.60	$522.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.16 / $356.55 / $573.09	Professional		$94.16	$356.55	$573.09
United Facility/Professional Professional Modifier Low / Median / High Price $283.83 / $416.83 / $636.34	Professional		$283.83	$416.83	$636.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.17 / $98.85 / $143.09	Professional	26	$82.17	$98.85	$143.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $214.24 / $348.58 / $493.15	Professional	TC	$214.24	$348.58	$493.15