Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $74.13 / $77.62	Facility	26	$72.44	$74.13	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $602.56	Professional		$169.82	$275.42	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $69.18 / $154.88	Professional	26	$51.29	$69.18	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $208.93 / $407.38	Professional	TC	$134.90	$208.93	$407.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $53.70 / $114.82	Professional	26	$40.74	$53.70	$114.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $562.34 / $588.84	Professional		$295.12	$562.34	$588.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $91.20 / $123.03	Professional	26	$91.20	$91.20	$123.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $93.33	Facility	26	$13.80	$64.57	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $371.54 / $645.65	Professional		$208.93	$371.54	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $79.43 / $165.96	Professional	26	$47.86	$79.43	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $269.15 / $512.86	Professional	TC	$151.36	$269.15	$512.86
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $77.62 / $138.04	Facility	26	$51.29	$77.62	$138.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $316.23 / $588.84	Professional		$194.98	$316.23	$588.84
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $69.18 / $138.04	Professional	26	$50.12	$69.18	$138.04
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $239.88 / $436.52	Professional	TC	$144.54	$239.88	$436.52
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $93.33	Facility	26	$13.80	$64.57	$93.33
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $288.40 / $707.95	Professional		$169.82	$288.40	$707.95
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $63.10 / $128.82	Professional	26	$43.65	$63.10	$128.82
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $218.78 / $512.86	Professional	TC	$117.49	$218.78	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $478.63	Professional		$213.80	$309.03	$478.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $100.00	Professional	26	$53.70	$64.57	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $239.88 / $380.19	Professional	TC	$158.49	$239.88	$380.19