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 / $138.04	Facility	26	$109.65	$109.65	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $457.09 / $912.01	Professional		$281.84	$457.09	$912.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $380.19	Professional	26	$85.11	$141.25	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $338.84 / $616.60	Professional	TC	$194.98	$338.84	$616.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Professional		$371.54	$371.54	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $81.28	Professional	26	$79.43	$79.43	$81.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $416.87 / $446.68	Professional		$288.40	$416.87	$446.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $134.90 / $181.97	Professional	26	$134.90	$134.90	$181.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $309.03 / $309.03	Professional	TC	$309.03	$309.03	$309.03
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 $281.84 / $524.81 / $1,071.52	Professional		$281.84	$524.81	$1,071.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $117.49 / $251.19	Professional	26	$70.79	$117.49	$251.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $371.54 / $794.33	Professional	TC	$194.98	$371.54	$794.33
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $138.04 / $218.78	Facility	26	$81.28	$138.04	$218.78
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $457.09 / $870.96	Professional		$295.12	$457.09	$870.96
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $114.82 / $239.88	Professional	26	$79.43	$114.82	$239.88
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $338.84 / $616.60	Professional	TC	$208.93	$338.84	$616.60
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 $239.88 / $467.74 / $1,047.13	Professional		$239.88	$467.74	$1,047.13
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $100.00 / $204.17	Professional	26	$64.57	$100.00	$204.17
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $331.13 / $776.25	Professional	TC	$169.82	$331.13	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $707.95	Professional		$281.84	$380.19	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $100.00 / $147.91	Professional	26	$81.28	$100.00	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $275.42 / $575.44	Professional	TC	$204.17	$275.42	$575.44