Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $69.18 / $83.18	Facility	26	$66.07	$69.18	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $257.04 / $562.34	Professional		$158.49	$257.04	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $93.33 / $218.78	Professional	26	$52.48	$93.33	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $154.88 / $416.87	Professional	TC	$102.33	$154.88	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $123.03	Professional		$120.23	$120.23	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $51.29 / $112.20	Professional	26	$42.66	$51.29	$112.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $229.09 / $245.47	Professional		$181.97	$229.09	$245.47
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 $162.18 / $162.18 / $218.78	Professional	TC	$162.18	$162.18	$218.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $120.23 / $204.17	Professional		$58.88	$120.23	$204.17
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 $151.36 / $269.15 / $537.03	Professional		$151.36	$269.15	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $75.86 / $154.88	Professional	26	$44.67	$75.86	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $181.97 / $380.19	Professional	TC	$100.00	$181.97	$380.19
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $69.18 / $138.04	Facility	26	$66.07	$69.18	$138.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $257.04 / $512.86	Professional		$165.96	$257.04	$512.86
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $74.13 / $194.98	Professional	26	$52.48	$74.13	$194.98
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $186.21 / $338.84	Professional	TC	$109.65	$186.21	$338.84
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 $131.83 / $245.47 / $549.54	Professional		$131.83	$245.47	$549.54
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $63.10 / $134.90	Professional	26	$43.65	$63.10	$134.90
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $173.78 / $371.54	Professional	TC	$83.18	$173.78	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $234.42 / $371.54	Professional		$154.88	$234.42	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $95.50	Professional	26	$52.48	$64.57	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $158.49 / $275.42	Professional	TC	$100.00	$158.49	$275.42