Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $109.65 / $114.82	Facility	26	$104.71	$109.65	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $1,023.29	Professional		$346.74	$478.63	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $331.13	Professional	26	$85.11	$141.25	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $354.81 / $794.33	Professional	TC	$257.04	$354.81	$794.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $75.86 / $81.28	Professional	26	$75.86	$75.86	$81.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $512.86 / $549.54	Professional		$489.78	$512.86	$549.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $134.90 / $181.97	Professional	26	$134.90	$134.90	$181.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $95.50 / $138.04	Facility	26	$20.89	$95.50	$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 / $245.47	Professional	26	$70.79	$112.20	$245.47
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 $74.13 / $114.82 / $204.17	Facility	26	$74.13	$114.82	$204.17
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $478.63 / $933.25	Professional		$363.08	$478.63	$933.25
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $114.82 / $288.40	Professional	26	$77.62	$114.82	$288.40
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $371.54 / $758.58	Professional	TC	$263.03	$371.54	$758.58
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $95.50 / $138.04	Facility	26	$20.89	$95.50	$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 $223.87 / $389.05 / $870.96	Professional	TC	$223.87	$389.05	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $467.74 / $741.31	Professional		$354.81	$467.74	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $93.33 / $147.91	Professional	26	$79.43	$93.33	$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