Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.06 / $65.59 / $65.59	Facility	26	$52.06	$65.59	$65.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.25 / $140.97 / $181.50	Professional		$115.25	$140.97	$181.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.89 / $46.88 / $60.71	Professional	26	$40.89	$46.88	$60.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.83 / $92.34 / $127.51	Professional	TC	$74.83	$92.34	$127.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.63 / $114.26 / $114.26	Professional		$106.63	$114.26	$114.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.46 / $43.22 / $43.22	Professional	26	$38.46	$43.22	$43.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $167.00 / $210.95	Professional		$68.48	$167.00	$210.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.77 / $69.77 / $69.77	Professional	26	$69.77	$69.77	$69.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.19 / $209.12 / $512.19	Professional		$113.19	$209.12	$512.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.19 / $69.64 / $185.60	Professional	26	$38.19	$69.64	$185.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.70 / $137.22 / $338.65	Professional	TC	$70.70	$137.22	$338.65
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $44.85 / $44.85 / $65.59	Facility	26	$44.85	$44.85	$65.59
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $122.25 / $148.08 / $207.17	Professional		$122.25	$148.08	$207.17
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.74 / $48.96 / $68.28	Professional	26	$42.74	$48.96	$68.28
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $75.31 / $105.15 / $139.51	Professional	TC	$75.31	$105.15	$139.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.83 / $82.72 / $161.73	Professional		$35.83	$82.72	$161.73
United Facility/Professional Professional Modifier Low / Median / High Price $117.08 / $144.51 / $231.35	Professional		$117.08	$144.51	$231.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.49 / $52.01 / $75.18	Professional	26	$43.49	$52.01	$75.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.13 / $93.72 / $162.58	Professional	TC	$68.13	$93.72	$162.58