Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Facility	26	$91.20	$91.20	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $812.83	Professional		$251.19	$426.58	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $229.09	Professional	26	$70.79	$120.23	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $302.00 / $562.34	Professional	TC	$186.21	$302.00	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $398.11	Professional		$257.04	$371.54	$398.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $112.20 / $151.36	Professional	26	$112.20	$112.20	$151.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $81.28 / $114.82	Facility	26	$17.38	$81.28	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $501.19 / $933.25	Professional		$251.19	$501.19	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $87.10 / $208.93	Professional	26	$53.70	$87.10	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $363.08 / $812.83	Professional	TC	$181.97	$363.08	$812.83
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $123.03 / $138.04	Facility	26	$50.12	$123.03	$138.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $436.52 / $851.14	Professional		$263.03	$436.52	$851.14
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $91.20 / $208.93	Professional	26	$52.48	$91.20	$208.93
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $346.74 / $602.56	Professional	TC	$186.21	$346.74	$602.56
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $81.28 / $114.82	Facility	26	$17.38	$81.28	$114.82
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $426.58 / $954.99	Professional		$213.80	$426.58	$954.99
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $70.79 / $154.88	Professional	26	$47.86	$70.79	$154.88
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $346.74 / $851.14	Professional	TC	$151.36	$346.74	$851.14
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $416.87 / $645.65	Professional		$251.19	$416.87	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $112.20	Professional	26	$54.95	$72.44	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $338.84 / $562.34	Professional	TC	$181.97	$338.84	$562.34