Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $89.13 / $112.20	Facility	26	$89.13	$89.13	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $467.74 / $977.24	Professional		$269.15	$467.74	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $131.83 / $281.84	Professional	26	$70.79	$131.83	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $338.84 / $630.96	Professional	TC	$204.17	$338.84	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $89.13	Professional	26	$67.61	$67.61	$89.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $398.11 / $426.58	Professional		$295.12	$398.11	$426.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $109.65 / $147.91	Professional	26	$109.65	$109.65	$147.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $112.20	Facility	26	$16.98	$79.43	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $501.19 / $870.96	Professional		$269.15	$501.19	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $93.33 / $204.17	Professional	26	$58.88	$93.33	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $371.54 / $691.83	Professional	TC	$204.17	$371.54	$691.83
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $112.20 / $165.96	Facility	26	$61.66	$112.20	$165.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $851.14	Professional		$275.42	$426.58	$851.14
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $104.71 / $229.09	Professional	26	$63.10	$104.71	$229.09
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $316.23 / $630.96	Professional	TC	$204.17	$316.23	$630.96
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $112.20	Facility	26	$16.98	$79.43	$112.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $416.87 / $933.25	Professional		$234.42	$416.87	$933.25
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $77.62 / $154.88	Professional	26	$53.70	$77.62	$154.88
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $295.12 / $660.69	Professional	TC	$173.78	$295.12	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $380.19 / $616.60	Professional		$275.42	$380.19	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $77.62 / $123.03	Professional	26	$66.07	$77.62	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $281.84 / $489.78	Professional	TC	$208.93	$281.84	$489.78