Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $125.89 / $154.88	Facility	26	$123.03	$125.89	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $436.52 / $812.83	Professional		$338.84	$436.52	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $123.03 / $331.13	Professional	26	$89.13	$123.03	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $549.54	Professional	TC	$245.47	$338.84	$549.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $104.71 / $151.36	Professional	26	$85.11	$104.71	$151.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $602.56 / $645.65	Professional		$446.68	$602.56	$645.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	26	$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $537.03 / $891.25	Professional		$389.05	$537.03	$891.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $131.83 / $234.42	Professional	26	$89.13	$131.83	$234.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $398.11 / $691.83	Professional	TC	$295.12	$398.11	$691.83
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $128.82 / $295.12	Facility	26	$123.03	$128.82	$295.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $467.74 / $758.58	Professional		$389.05	$467.74	$758.58
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $123.03 / $239.88	Professional	26	$97.72	$123.03	$239.88
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $346.74 / $575.44	Professional	TC	$295.12	$346.74	$575.44
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $537.03 / $891.25	Professional		$346.74	$537.03	$891.25
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $131.83 / $234.42	Professional	26	$81.28	$131.83	$234.42
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $398.11 / $691.83	Professional	TC	$263.03	$398.11	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $501.19 / $691.83	Professional		$389.05	$501.19	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $123.03 / $169.82	Professional	26	$95.50	$123.03	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $389.05 / $524.81	Professional	TC	$295.12	$389.05	$524.81