Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.73 / $117.73 / $117.73	Facility	26	$117.73	$117.73	$117.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.37 / $328.10 / $433.26	Professional		$252.37	$328.10	$433.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.90 / $104.21 / $129.97	Professional	26	$93.90	$104.21	$129.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $157.94 / $216.31 / $318.50	Professional	TC	$157.94	$216.31	$318.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $259.89 / $281.49 / $281.49	Professional		$259.89	$281.49	$281.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.38 / $305.31 / $477.11	Professional		$148.38	$305.31	$477.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $158.71 / $158.71 / $158.71	Professional	26	$158.71	$158.71	$158.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.62 / $444.82 / $1,264.65	Professional		$194.62	$444.82	$1,264.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.85 / $154.08 / $424.43	Professional	26	$86.85	$154.08	$424.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.55 / $292.07 / $840.22	Professional	TC	$117.55	$292.07	$840.22
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $98.37 / $98.37 / $117.73	Facility	26	$98.37	$98.37	$117.73
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $274.77 / $355.89 / $515.27	Professional		$274.77	$355.89	$515.27
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $94.31 / $110.17 / $155.77	Professional	26	$94.31	$110.17	$155.77
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $176.35 / $253.00 / $359.03	Professional	TC	$176.35	$253.00	$359.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.16 / $201.05 / $349.46	Professional		$94.16	$201.05	$349.46
United Facility/Professional Professional Modifier Low / Median / High Price $230.45 / $307.58 / $500.23	Professional		$230.45	$307.58	$500.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.02 / $116.71 / $165.46	Professional	26	$97.02	$116.71	$165.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.66 / $198.61 / $372.76	Professional	TC	$139.66	$198.61	$372.76