Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $87.10	Facility	26	$69.18	$69.18	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $281.84 / $602.56	Professional		$181.97	$281.84	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $87.10 / $213.80	Professional	26	$52.48	$87.10	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $213.80 / $446.68	Professional	TC	$125.89	$213.80	$446.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $50.12 / $89.13	Professional	26	$42.66	$50.12	$89.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $275.42 / $295.12	Professional		$194.98	$275.42	$295.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $85.11 / $114.82	Professional	26	$85.11	$85.11	$114.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	TC	$208.93	$208.93	$208.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $60.26 / $87.10	Facility	26	$13.18	$60.26	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $338.84 / $645.65	Professional		$190.55	$338.84	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $75.86 / $158.49	Professional	26	$45.71	$75.86	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $245.47 / $478.63	Professional	TC	$138.04	$245.47	$478.63
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $72.44 / $158.49	Facility	26	$66.07	$72.44	$158.49
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $575.44	Professional		$194.98	$302.00	$575.44
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $74.13 / $190.55	Professional	26	$53.70	$74.13	$190.55
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $218.78 / $426.58	Professional	TC	$138.04	$218.78	$426.58
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $60.26 / $87.10	Facility	26	$13.18	$60.26	$87.10
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $275.42 / $660.69	Professional		$158.49	$275.42	$660.69
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $70.79 / $141.25	Professional	26	$44.67	$70.79	$141.25
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $199.53 / $478.63	Professional	TC	$107.15	$199.53	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $295.12 / $446.68	Professional		$204.17	$295.12	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $69.18 / $102.33	Professional	26	$53.70	$69.18	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $223.87 / $346.74	Professional	TC	$151.36	$223.87	$346.74