Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $35.48 / $45.71	Facility	26	$35.48	$35.48	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $123.03 / $416.87	Professional		$66.07	$123.03	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $39.81 / $87.10	Professional	26	$25.12	$39.81	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $89.13 / $218.78	Professional	TC	$42.66	$89.13	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $26.92 / $45.71	Professional	26	$22.91	$26.92	$45.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $151.36 / $151.36	Professional		$112.20	$151.36	$151.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $85.11 / $141.25	Professional		$30.20	$85.11	$141.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	26	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $144.54 / $323.59	Professional		$87.10	$144.54	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.02 / $83.18	Professional	26	$22.91	$38.02	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $102.33 / $218.78	Professional	TC	$61.66	$102.33	$218.78
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $35.48 / $61.66	Facility	26	$34.67	$35.48	$61.66
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $123.03 / $281.84	Professional		$74.13	$123.03	$281.84
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $34.67 / $77.62	Professional	26	$23.99	$34.67	$77.62
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $89.13 / $190.55	Professional	TC	$50.12	$89.13	$190.55
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	26	$6.76	$31.62	$44.67
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $275.42	Professional		$81.28	$107.15	$275.42
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.20 / $72.44	Professional	26	$20.89	$30.20	$72.44
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $75.86 / $194.98	Professional	TC	$58.88	$75.86	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $158.49	Professional		$89.13	$107.15	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $29.51 / $47.86	Professional	26	$24.55	$29.51	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $77.62 / $114.82	Professional	TC	$60.26	$77.62	$114.82