Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $1,122.02	Professional		$346.74	$478.63	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $131.83 / $269.15	Professional	26	$85.11	$131.83	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $691.83	Professional	TC	$257.04	$338.84	$691.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $977.24 / $1,023.29	Professional		$512.86	$977.24	$1,023.29
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $134.90 / $181.97	Professional	26	$134.90	$134.90	$181.97
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,096.48 / $1,096.48 / $1,479.11	Professional	50	$1,096.48	$1,096.48	$1,479.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $588.84 / $1,047.13	Professional		$338.84	$588.84	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $112.20 / $251.19	Professional	26	$70.79	$112.20	$251.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $478.63 / $851.14	Professional	TC	$263.03	$478.63	$851.14
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $186.21 / $208.93	Facility	26	$75.86	$186.21	$208.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $933.25	Professional		$346.74	$478.63	$933.25
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $109.65 / $218.78	Professional	26	$70.79	$109.65	$218.78
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $346.74 / $691.83	Professional	TC	$257.04	$346.74	$691.83
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $524.81 / $1,047.13	Professional		$295.12	$524.81	$1,047.13
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $95.50 / $208.93	Professional	26	$64.57	$95.50	$208.93
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $389.05 / $870.96	Professional	TC	$218.78	$389.05	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $467.74 / $758.58	Professional		$354.81	$467.74	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $95.50 / $147.91	Professional	26	$79.43	$95.50	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $363.08 / $602.56	Professional	TC	$269.15	$363.08	$602.56