Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $134.90 / $169.82	Facility	26	$131.83	$134.90	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $501.19 / $1,258.93	Professional		$338.84	$501.19	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $138.04 / $407.38	Professional	26	$93.33	$138.04	$407.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $363.08 / $645.65	Professional	TC	$239.88	$363.08	$645.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $309.03	Professional		$302.00	$302.00	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $102.33 / $199.53	Professional	26	$81.28	$102.33	$199.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $616.60	Professional		$398.11	$575.44	$616.60
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $165.96 / $165.96	Professional	26	$165.96	$165.96	$165.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $446.68 / $446.68	Professional	TC	$446.68	$446.68	$446.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $323.59 / $537.03	Professional		$114.82	$323.59	$537.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $117.49 / $169.82	Facility	26	$25.70	$117.49	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $602.56 / $1,174.90	Professional		$331.13	$602.56	$1,174.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $131.83 / $302.00	Professional	26	$87.10	$131.83	$302.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $457.09 / $870.96	Professional	TC	$239.88	$457.09	$870.96
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $134.90 / $223.87	Facility	26	$131.83	$134.90	$223.87
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $512.86 / $954.99	Professional		$380.19	$512.86	$954.99
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $134.90 / $354.81	Professional	26	$91.20	$134.90	$354.81
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $398.11 / $645.65	Professional	TC	$281.84	$398.11	$645.65
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $117.49 / $169.82	Facility	26	$25.70	$117.49	$169.82
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $426.58 / $1,071.52	Professional		$309.03	$426.58	$1,071.52
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $112.20 / $229.09	Professional	26	$81.28	$112.20	$229.09
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $338.84 / $891.25	Professional	TC	$229.09	$338.84	$891.25
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $512.86 / $758.58	Professional		$380.19	$512.86	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $120.23 / $181.97	Professional	26	$97.72	$120.23	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $398.11 / $588.84	Professional	TC	$269.15	$398.11	$588.84