Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $26.92 / $26.92	Facility	26	$26.92	$26.92	$26.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $275.42	Professional		$93.33	$131.83	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $112.20 / $234.42	Professional	TC	$77.62	$112.20	$234.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $199.53 / $213.80	Professional		$165.96	$199.53	$213.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	26	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $169.82 / $380.19	Professional		$95.50	$169.82	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $138.04 / $338.84	Professional	TC	$79.43	$138.04	$338.84
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $51.29 / $57.54	Facility	26	$20.89	$51.29	$57.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $181.97	Professional		$91.20	$131.83	$181.97
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $107.15 / $151.36	Professional	TC	$72.44	$107.15	$151.36
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	26	$5.62	$26.30	$38.02
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $128.82 / $295.12	Professional		$87.10	$128.82	$295.12
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $107.15 / $316.23	Professional	TC	$70.79	$107.15	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $125.89 / $199.53	Professional		$104.71	$125.89	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $102.33 / $162.18	Professional	TC	$81.28	$102.33	$162.18