Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.75 / $74.75 / $791.15	Facility		$74.75	$74.75	$791.15
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.33 / $21.34 / $21.34	Facility	26	$21.33	$21.34	$21.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.21 / $90.42 / $166.05	Professional		$62.21	$90.42	$166.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.67 / $18.67 / $28.45	Professional	26	$16.67	$18.67	$28.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.68 / $76.12 / $147.55	Professional	TC	$45.68	$76.12	$147.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.52 / $59.52 / $63.82	Professional		$59.52	$59.52	$63.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.00 / $34.00 / $34.00	Professional	26	$34.00	$34.00	$34.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.23 / $205.66 / $429.00	Facility		$97.23	$205.66	$429.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.23 / $93.67 / $113.39	Professional		$28.23	$93.67	$113.39
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.76 / $28.76 / $28.76	Professional	26	$28.76	$28.76	$28.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.96 / $136.97 / $287.75	Professional		$61.96	$136.97	$287.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.73 / $27.55 / $76.25	Professional	26	$15.73	$27.55	$76.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.04 / $107.81 / $229.10	Professional	TC	$42.04	$107.81	$229.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $74.75 / $145.82 / $791.15	Facility		$74.75	$145.82	$791.15
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $17.26 / $17.26 / $21.34	Facility	26	$17.26	$17.26	$21.34
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $67.44 / $118.81 / $168.97	Professional		$67.44	$118.81	$168.97
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.73 / $19.84 / $28.46	Professional	26	$16.73	$19.84	$28.46
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $48.89 / $90.34 / $147.84	Professional	TC	$48.89	$90.34	$147.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $52.11 / $86.11	Professional		$28.70	$52.11	$86.11
United Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $112.22 / $159.21	Professional		$67.84	$112.22	$159.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.22 / $21.05 / $30.58	Professional	26	$17.22	$21.05	$30.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.72 / $88.64 / $136.77	Professional	TC	$48.72	$88.64	$136.77