Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $37.15 / $37.15	Facility	26	$37.15	$37.15	$37.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $263.03	Professional		$63.10	$87.10	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $33.11 / $123.03	Professional	26	$25.70	$33.11	$123.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $144.54 / $295.12 / $977.24	Professional	50	$144.54	$295.12	$977.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $47.86 / $93.33	Professional	TC	$34.67	$47.86	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $74.13	Professional		$61.66	$61.66	$74.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $208.93 / $223.87	Professional		$63.10	$208.93	$223.87
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $239.88 / $239.88 / $239.88	Professional	50	$239.88	$239.88	$239.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $36.31 / $51.29	Facility	26	$7.76	$36.31	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $104.71 / $213.80	Professional		$63.10	$104.71	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $41.69 / $91.20	Professional	26	$26.30	$41.69	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $63.10 / $134.90	Professional	TC	$38.90	$63.10	$134.90
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $67.61 / $79.43	Facility	26	$28.84	$67.61	$79.43
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $85.11 / $158.49	Professional		$66.07	$85.11	$158.49
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.88 / $63.10	Professional	26	$26.92	$33.88	$63.10
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $173.78 / $204.17 / $407.38	Professional	50	$173.78	$204.17	$407.38
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $48.98 / $85.11	Professional	TC	$38.02	$48.98	$85.11
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $36.31 / $51.29	Facility	26	$7.76	$36.31	$51.29
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $95.50 / $194.98	Professional		$60.26	$95.50	$194.98
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $36.31 / $72.44	Professional	26	$22.91	$36.31	$72.44
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $61.66 / $120.23	Professional	TC	$38.02	$61.66	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $102.33 / $141.25	Professional		$77.62	$102.33	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $37.15 / $53.70	Professional	26	$30.90	$37.15	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $64.57 / $87.10	Professional	TC	$46.77	$64.57	$87.10