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 / $177.83	Facility	26	$138.04	$141.25	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $524.81 / $2,290.87	Professional		$331.13	$524.81	$2,290.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $194.98 / $524.81	Professional	26	$107.15	$194.98	$524.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $338.84 / $758.58	Professional	TC	$218.78	$338.84	$758.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $269.15 / $436.52	Professional		$234.42	$269.15	$436.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $107.15 / $204.17	Professional	26	$81.28	$107.15	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $489.78 / $524.81	Professional		$323.59	$489.78	$524.81
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $173.78 / $234.42	Professional	26	$173.78	$173.78	$234.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $346.74 / $346.74	Professional	TC	$346.74	$346.74	$346.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $251.19 / $436.52	Professional		$120.23	$251.19	$436.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $123.03 / $177.83	Facility	26	$26.92	$123.03	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $630.96 / $1,258.93	Professional		$331.13	$630.96	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $154.88 / $316.23	Professional	26	$91.20	$154.88	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $416.87 / $1,023.29	Professional	TC	$223.87	$416.87	$1,023.29
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $141.25 / $275.42	Facility	26	$134.90	$141.25	$275.42
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $512.86 / $1,148.15	Professional		$354.81	$512.86	$1,148.15
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $158.49 / $467.74	Professional	26	$107.15	$158.49	$467.74
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $354.81 / $691.83	Professional	TC	$234.42	$354.81	$691.83
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $123.03 / $177.83	Facility	26	$26.92	$123.03	$177.83
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $549.54 / $1,202.26	Professional		$281.84	$549.54	$1,202.26
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $128.82 / $269.15	Professional	26	$85.11	$128.82	$269.15
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $389.05 / $1,047.13	Professional	TC	$190.55	$389.05	$1,047.13
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $446.68 / $1,122.02	Professional		$331.13	$446.68	$1,122.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $128.82 / $190.55	Professional	26	$104.71	$128.82	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $309.03 / $831.76	Professional	TC	$229.09	$309.03	$831.76