Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $24.55 / $30.20	Facility	26	$23.99	$24.55	$30.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $112.20 / $229.09	Professional		$70.79	$112.20	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $26.92 / $66.07	Professional	26	$16.98	$26.92	$66.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $81.28 / $158.49	Professional	TC	$54.95	$81.28	$158.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $134.90	Professional		$61.66	$75.86	$134.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $18.62 / $30.20	Professional	26	$15.14	$18.62	$30.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $147.91 / $158.49	Professional		$117.49	$147.91	$158.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Professional	26	$31.62	$31.62	$31.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.90 / $22.91 / $32.36	Facility	26	$4.90	$22.91	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $120.23 / $269.15	Professional		$74.13	$120.23	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $27.54 / $58.88	Professional	26	$16.22	$27.54	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $95.50 / $229.09	Professional	TC	$56.23	$95.50	$229.09
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $25.12 / $45.71	Facility	26	$22.91	$25.12	$45.71
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $104.71 / $199.53	Professional		$63.10	$104.71	$199.53
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $22.91 / $57.54	Professional	26	$15.85	$22.91	$57.54
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $81.28 / $154.88	Professional	TC	$47.86	$81.28	$154.88
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $4.90 / $22.91 / $32.36	Facility	26	$4.90	$22.91	$32.36
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $208.93	Professional		$64.57	$89.13	$208.93
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $22.39 / $53.70	Professional	26	$15.14	$22.39	$53.70
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $74.13 / $213.80	Professional	TC	$48.98	$74.13	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $141.25	Professional		$75.86	$89.13	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $22.39 / $33.88	Professional	26	$18.62	$22.39	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $69.18 / $109.65	Professional	TC	$56.23	$69.18	$109.65