Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $89.13	Facility	26	$70.79	$70.79	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $257.04 / $524.81	Professional		$114.82	$257.04	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $83.18 / $177.83	Professional	26	$51.29	$83.18	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $204.17 / $426.58	Professional	TC	$144.54	$204.17	$426.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $51.29 / $89.13	Professional	26	$40.74	$51.29	$89.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $323.59 / $602.56	Professional		$208.93	$323.59	$602.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $87.10 / $117.49	Professional	26	$87.10	$87.10	$117.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $234.42 / $234.42	Professional	TC	$234.42	$234.42	$234.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $61.66 / $89.13	Facility	26	$13.49	$61.66	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $316.23 / $616.60	Professional		$194.98	$316.23	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $75.86 / $158.49	Professional	26	$45.71	$75.86	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $234.42 / $457.09	Professional	TC	$144.54	$234.42	$457.09
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $72.44 / $131.83	Facility	26	$67.61	$72.44	$131.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $269.15 / $537.03	Professional		$194.98	$269.15	$537.03
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $70.79 / $154.88	Professional	26	$50.12	$70.79	$154.88
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $213.80 / $416.87	Professional	TC	$158.49	$213.80	$416.87
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $61.66 / $89.13	Facility	26	$13.49	$61.66	$89.13
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $549.54	Professional		$169.82	$251.19	$549.54
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $60.26 / $123.03	Professional	26	$40.74	$60.26	$123.03
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $177.83 / $426.58	Professional	TC	$125.89	$177.83	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $263.03 / $416.87	Professional		$204.17	$263.03	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $61.66 / $95.50	Professional	26	$51.29	$61.66	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $194.98 / $323.59	Professional	TC	$147.91	$194.98	$323.59