Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $100.00 / $125.89	Facility	26	$95.50	$100.00	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $478.63 / $1,096.48	Professional		$251.19	$478.63	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $141.25 / $380.19	Professional	26	$77.62	$141.25	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $676.08	Professional	TC	$245.47	$338.84	$676.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $309.03	Professional		$295.12	$295.12	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $123.03	Professional	26	$57.54	$72.44	$123.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $213.80 / $257.04	Professional	TC	$213.80	$213.80	$257.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $501.19 / $954.99	Professional		$363.08	$501.19	$954.99
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $165.96	Professional	26	$123.03	$123.03	$165.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $380.19 / $380.19	Professional	TC	$380.19	$380.19	$380.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $275.42 / $389.05	Professional		$79.43	$275.42	$389.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $125.89	Facility	26	$18.62	$87.10	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $537.03 / $1,023.29	Professional		$316.23	$537.03	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $102.33 / $223.87	Professional	26	$64.57	$102.33	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $446.68 / $831.76	Professional	TC	$251.19	$446.68	$831.76
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $102.33 / $186.21	Facility	26	$95.50	$102.33	$186.21
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $478.63 / $1,023.29	Professional		$338.84	$478.63	$1,023.29
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $120.23 / $295.12	Professional	26	$74.13	$120.23	$295.12
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $354.81 / $724.44	Professional	TC	$263.03	$354.81	$724.44
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $125.89	Facility	26	$18.62	$87.10	$125.89
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $478.63 / $977.24	Professional		$275.42	$478.63	$977.24
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $173.78	Professional	26	$58.88	$85.11	$173.78
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $346.74 / $831.76	Professional	TC	$213.80	$346.74	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $446.68 / $724.44	Professional		$331.13	$446.68	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $85.11 / $134.90	Professional	26	$72.44	$85.11	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $346.74 / $602.56	Professional	TC	$257.04	$346.74	$602.56