Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $79.43 / $79.43	Facility	26	$77.62	$79.43	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $275.42 / $501.19	Professional		$173.78	$275.42	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $63.10 / $154.88	Professional	26	$51.29	$63.10	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $194.98 / $457.09	Professional	TC	$128.82	$194.98	$457.09
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $41.69 / $41.69 / $41.69	Professional	52	$41.69	$41.69	$41.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $323.59 / $346.74	Professional		$234.42	$323.59	$346.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	26	$97.72	$97.72	$97.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $251.19 / $251.19	Professional	TC	$251.19	$251.19	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $302.00 / $489.78	Professional		$199.53	$302.00	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $79.43 / $128.82	Professional	26	$43.65	$79.43	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $257.04 / $371.54	Professional	TC	$144.54	$257.04	$371.54
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $125.89 / $138.04	Facility	26	$50.12	$125.89	$138.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $281.84 / $436.52	Professional		$218.78	$281.84	$436.52
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $66.07 / $97.72	Professional	26	$47.86	$66.07	$97.72
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $234.42 / $389.05	Professional	TC	$158.49	$234.42	$389.05
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $295.12 / $489.78	Professional		$199.53	$295.12	$489.78
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $79.43 / $134.90	Professional	26	$43.65	$79.43	$134.90
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $208.93 / $371.54	Professional	TC	$141.25	$208.93	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $354.81 / $707.95	Professional		$213.80	$354.81	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $100.00	Professional	26	$53.70	$64.57	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $245.47 / $645.65	Professional	TC	$151.36	$245.47	$645.65