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 $275.42 / $457.09 / $870.96	Professional		$275.42	$457.09	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $398.11	Professional	26	$85.11	$141.25	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $331.13 / $630.96	Professional	TC	$190.55	$331.13	$630.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $79.43 / $83.18	Professional	26	$75.86	$79.43	$83.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $407.38 / $436.52	Professional		$281.84	$407.38	$436.52
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 $302.00 / $302.00 / $302.00	Professional	TC	$302.00	$302.00	$302.00
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 $275.42 / $512.86 / $1,000.00	Professional		$275.42	$512.86	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $112.20 / $245.47	Professional	26	$70.79	$112.20	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $363.08 / $794.33	Professional	TC	$194.98	$363.08	$794.33
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $173.78 / $204.17	Facility	26	$75.86	$173.78	$204.17
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $467.74 / $870.96	Professional		$288.40	$467.74	$870.96
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $114.82 / $269.15	Professional	26	$74.13	$114.82	$269.15
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $338.84 / $645.65	Professional	TC	$199.53	$338.84	$645.65
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 $234.42 / $446.68 / $1,000.00	Professional		$234.42	$446.68	$1,000.00
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $95.50 / $186.21	Professional	26	$64.57	$95.50	$186.21
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $331.13 / $758.58	Professional	TC	$165.96	$331.13	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $380.19 / $707.95	Professional		$275.42	$380.19	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $93.33 / $147.91	Professional	26	$79.43	$93.33	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $269.15 / $575.44	Professional	TC	$199.53	$269.15	$575.44