Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $91.20 / $112.20	Facility	26	$89.13	$91.20	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $478.63 / $1,000.00	Professional		$288.40	$478.63	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $125.89 / $323.59	Professional	26	$70.79	$125.89	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $338.84 / $630.96	Professional	TC	$223.87	$338.84	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Professional		$363.08	$363.08	$363.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $64.57 / $89.13	Professional	26	$64.57	$64.57	$89.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $512.86 / $537.03	Professional		$407.38	$512.86	$537.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $109.65 / $147.91	Professional	26	$109.65	$109.65	$147.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $436.52 / $436.52	Professional	TC	$436.52	$436.52	$436.52
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 $338.84 / $575.44 / $1,047.13	Professional		$338.84	$575.44	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $91.20 / $204.17	Professional	26	$57.54	$91.20	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $467.74 / $891.25	Professional	TC	$281.84	$467.74	$891.25
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $112.20 / $165.96	Facility	26	$89.13	$112.20	$165.96
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $912.01	Professional		$331.13	$478.63	$912.01
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $104.71 / $239.88	Professional	26	$63.10	$104.71	$239.88
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $363.08 / $660.69	Professional	TC	$251.19	$363.08	$660.69
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 $302.00 / $446.68 / $1,000.00	Professional		$302.00	$446.68	$1,000.00
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $75.86 / $151.36	Professional	26	$52.48	$75.86	$151.36
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $354.81 / $912.01	Professional	TC	$239.88	$354.81	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $467.74 / $758.58	Professional		$346.74	$467.74	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $75.86 / $120.23	Professional	26	$64.57	$75.86	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $389.05 / $645.65	Professional	TC	$281.84	$389.05	$645.65