Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $93.33 / $112.20	Facility	26	$89.13	$93.33	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $338.84 / $758.58	Professional		$181.97	$338.84	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $109.65 / $302.00	Professional	26	$64.57	$109.65	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $190.55 / $371.54	Professional	TC	$123.03	$190.55	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $85.11	Professional	26	$67.61	$67.61	$85.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $331.13 / $354.81	Professional		$316.23	$331.13	$354.81
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	26	$120.23	$120.23	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $85.11 / $123.03	Facility	26	$18.62	$85.11	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $338.84 / $707.95	Professional		$204.17	$338.84	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $100.00 / $218.78	Professional	26	$63.10	$100.00	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $223.87 / $446.68	Professional	TC	$141.25	$223.87	$446.68
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $112.20 / $186.21	Facility	26	$89.13	$112.20	$186.21
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $263.03 / $645.65	Professional		$199.53	$263.03	$645.65
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $89.13 / $245.47	Professional	26	$64.57	$89.13	$245.47
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $173.78 / $389.05	Professional	TC	$134.90	$173.78	$389.05
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $85.11 / $123.03	Facility	26	$18.62	$85.11	$123.03
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $269.15 / $602.56	Professional		$186.21	$269.15	$602.56
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $83.18 / $199.53	Professional	26	$57.54	$83.18	$199.53
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $177.83 / $407.38	Professional	TC	$123.03	$177.83	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $512.86 / $1,023.29	Professional		$234.42	$512.86	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $85.11 / $134.90	Professional	26	$72.44	$85.11	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $380.19 / $912.01	Professional	TC	$158.49	$380.19	$912.01