Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.14	Facility	26	$15.14	$15.14	$15.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $112.20 / $275.42	Professional		$77.62	$112.20	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.13 / $51.29	Professional	26	$10.96	$14.13	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $95.50 / $223.87	Professional	TC	$67.61	$95.50	$223.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $9.55 / $19.50	Professional	26	$9.55	$9.55	$19.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $147.91 / $158.49	Professional		$131.83	$147.91	$158.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $18.62 / $18.62	Professional	26	$18.62	$18.62	$18.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.88 / $13.49 / $19.05	Facility	26	$2.88	$13.49	$19.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $165.96 / $331.13	Professional		$100.00	$165.96	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.79 / $34.67	Professional	26	$9.77	$14.79	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $144.54 / $275.42	Professional	TC	$87.10	$144.54	$275.42
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $25.12 / $27.54	Facility	26	$10.00	$25.12	$27.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $117.49 / $190.55	Professional		$91.20	$117.49	$190.55
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $13.18 / $24.55	Professional	26	$9.55	$13.18	$24.55
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $107.15 / $165.96	Professional	TC	$79.43	$107.15	$165.96
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $2.88 / $13.49 / $19.05	Facility	26	$2.88	$13.49	$19.05
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $138.04 / $281.84	Professional		$87.10	$138.04	$281.84
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.30 / $30.90	Professional	26	$8.32	$12.30	$30.90
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $117.49 / $269.15	Professional	TC	$77.62	$117.49	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $208.93	Professional		$100.00	$128.82	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.88 / $20.42	Professional	26	$10.96	$12.88	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $114.82 / $194.98	Professional	TC	$89.13	$114.82	$194.98