Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $141.25 / $177.83	Facility	26	$134.90	$141.25	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $489.78 / $1,778.28	Professional		$331.13	$489.78	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $190.55 / $512.86	Professional	26	$104.71	$190.55	$512.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $338.84 / $812.83	Professional	TC	$218.78	$338.84	$812.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $263.03 / $295.12	Professional		$239.88	$263.03	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $107.15 / $177.83	Professional	26	$81.28	$107.15	$177.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $154.88 / $154.88	Professional	TC	$154.88	$154.88	$154.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $478.63 / $512.86	Professional		$323.59	$478.63	$512.86
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 / $616.60 / $1,230.27	Professional		$331.13	$616.60	$1,230.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $147.91 / $316.23	Professional	26	$91.20	$147.91	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $416.87 / $1,047.13	Professional	TC	$218.78	$416.87	$1,047.13
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $141.25 / $251.19	Facility	26	$134.90	$141.25	$251.19
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $501.19 / $1,096.48	Professional		$354.81	$501.19	$1,096.48
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $154.88 / $457.09	Professional	26	$104.71	$154.88	$457.09
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $354.81 / $707.95	Professional	TC	$234.42	$354.81	$707.95
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 $81.28 / $123.03 / $251.19	Professional	26	$81.28	$123.03	$251.19
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $389.05 / $1,047.13	Professional	TC	$186.21	$389.05	$1,047.13
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $446.68 / $1,096.48	Professional		$331.13	$446.68	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $123.03 / $190.55	Professional	26	$102.33	$123.03	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $309.03 / $870.96	Professional	TC	$229.09	$309.03	$870.96