Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.75 / $53.75 / $53.75	Facility	26	$53.75	$53.75	$53.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.17 / $100.19 / $124.47	Professional		$89.17	$100.19	$124.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.27 / $53.95 / $65.51	Professional	TC	$45.27	$53.95	$65.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.39 / $90.09 / $147.34	Professional		$63.39	$90.09	$147.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $144.91 / $382.70	Professional		$73.48	$144.91	$382.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.58 / $72.95 / $192.79	Professional	TC	$34.58	$72.95	$192.79
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.55 / $46.55 / $53.75	Facility	26	$46.55	$46.55	$53.75
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $89.17 / $102.45 / $137.32	Professional		$89.17	$102.45	$137.32
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.93 / $55.89 / $72.81	Professional	TC	$44.93	$55.89	$72.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.54 / $46.17 / $120.26	Professional		$28.54	$46.17	$120.26
United Facility/Professional Professional Modifier Low / Median / High Price $81.47 / $105.72 / $158.91	Professional		$81.47	$105.72	$158.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.36 / $55.10 / $79.02	Professional	TC	$37.36	$55.10	$79.02