Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $114.82	Facility	26	$109.65	$109.65	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $512.86 / $1,548.82	Professional		$354.81	$512.86	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $147.91 / $363.08	Professional	26	$85.11	$147.91	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $363.08 / $870.96	Professional	TC	$263.03	$363.08	$870.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $81.28 / $181.97	Professional	26	$63.10	$81.28	$181.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $524.81 / $562.34	Professional		$416.87	$524.81	$562.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $134.90 / $134.90	Professional	26	$134.90	$134.90	$134.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $426.58 / $426.58	Professional	TC	$426.58	$426.58	$426.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $707.95 / $1,479.11	Professional		$354.81	$707.95	$1,479.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $112.20 / $251.19	Professional	26	$70.79	$112.20	$251.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $537.03 / $1,230.27	Professional	TC	$269.15	$537.03	$1,230.27
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $109.65 / $204.17	Facility	26	$104.71	$109.65	$204.17
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $588.84 / $1,202.26	Professional		$371.54	$588.84	$1,202.26
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $125.89 / $309.03	Professional	26	$81.28	$125.89	$309.03
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $426.58 / $870.96	Professional	TC	$269.15	$426.58	$870.96
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $616.60 / $1,479.11	Professional		$302.00	$616.60	$1,479.11
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $95.50 / $208.93	Professional	26	$64.57	$95.50	$208.93
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $489.78 / $1,288.25	Professional	TC	$223.87	$489.78	$1,288.25
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $602.56 / $1,047.13	Professional		$354.81	$602.56	$1,047.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $95.50 / $147.91	Professional	26	$79.43	$95.50	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $501.19 / $912.01	Professional	TC	$275.42	$501.19	$912.01