Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $141.25 / $173.78	Facility	26	$138.04	$141.25	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $602.56 / $2,290.87	Professional		$398.11	$602.56	$2,290.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $177.83 / $389.05	Professional	26	$107.15	$177.83	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $436.52 / $977.24	Professional	TC	$302.00	$436.52	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $416.87	Professional		$346.74	$346.74	$416.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $107.15 / $154.88	Professional	26	$100.00	$107.15	$154.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $707.95 / $758.58	Professional		$549.54	$707.95	$758.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $169.82 / $229.09	Professional	26	$169.82	$169.82	$229.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $123.03 / $173.78	Facility	26	$26.30	$123.03	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $812.83 / $1,548.82	Professional		$489.78	$812.83	$1,548.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $141.25 / $316.23	Professional	26	$89.13	$141.25	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $707.95 / $1,318.26	Professional	TC	$380.19	$707.95	$1,318.26
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $144.54 / $257.04	Facility	26	$138.04	$144.54	$257.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $630.96 / $1,412.54	Professional		$426.58	$630.96	$1,412.54
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $141.25 / $380.19	Professional	26	$97.72	$141.25	$380.19
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $512.86 / $977.24	Professional	TC	$338.84	$512.86	$977.24
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $123.03 / $173.78	Facility	26	$26.30	$123.03	$173.78
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $645.65 / $1,479.11	Professional		$416.87	$645.65	$1,479.11
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $117.49 / $234.42	Professional	26	$79.43	$117.49	$234.42
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $512.86 / $1,258.93	Professional	TC	$331.13	$512.86	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $676.08 / $1,148.15	Professional		$501.19	$676.08	$1,148.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $117.49 / $186.21	Professional	26	$100.00	$117.49	$186.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $537.03 / $977.24	Professional	TC	$398.11	$537.03	$977.24