Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $199.53 / $501.19	Facility		$131.83	$199.53	$501.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $31.62 / $39.81	Facility	26	$31.62	$31.62	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $295.12	Professional		$72.44	$125.89	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $31.62 / $93.33	Professional	26	$22.91	$31.62	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $87.10 / $154.88	Professional	TC	$50.12	$87.10	$154.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $123.03	Professional		$79.43	$93.33	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $27.54 / $38.90	Professional	26	$20.42	$27.54	$38.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $213.80 / $371.54	Facility		$138.04	$213.80	$371.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $169.82 / $181.97	Professional		$162.18	$169.82	$181.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $41.69 / $41.69	Professional	26	$41.69	$41.69	$41.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	TC	$138.04	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $125.89 / $181.97	Professional		$81.28	$125.89	$181.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $38.02 / $58.88	Professional	26	$22.39	$38.02	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $97.72 / $134.90	Professional	TC	$57.54	$97.72	$134.90
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $186.21 / $467.74	Facility		$131.83	$186.21	$467.74
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $32.36 / $58.88	Facility	26	$31.62	$32.36	$58.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $128.82 / $234.42	Professional		$67.61	$128.82	$234.42
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $31.62 / $74.13	Professional	26	$21.88	$31.62	$74.13
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $95.50 / $165.96	Professional	TC	$43.65	$95.50	$165.96
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $109.65 / $181.97	Professional		$81.28	$109.65	$181.97
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $38.02 / $58.88	Professional	26	$23.99	$38.02	$58.88
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $74.13 / $134.90	Professional	TC	$54.95	$74.13	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $138.04	Professional		$72.44	$102.33	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $29.51 / $34.67	Professional	26	$23.99	$29.51	$34.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $69.18 / $107.15	Professional	TC	$44.67	$69.18	$107.15