Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $47.86 / $58.88	Facility	26	$45.71	$47.86	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $120.23 / $218.78	Professional		$52.48	$120.23	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $39.81 / $97.72	Professional	26	$30.90	$39.81	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $85.11 / $144.54	Professional	TC	$15.85	$85.11	$144.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $75.86 / $81.28	Professional		$63.10	$75.86	$81.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	26	$67.61	$67.61	$67.61
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $14.79 / $14.79	Professional	TC	$14.79	$14.79	$14.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $104.71 / $251.19	Professional		$45.71	$104.71	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $52.48 / $89.13	Professional	26	$34.67	$52.48	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.23 / $58.88 / $154.88	Professional	TC	$10.23	$58.88	$154.88
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $58.88 / $95.50	Facility	26	$45.71	$58.88	$95.50
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $85.11 / $204.17	Professional		$43.65	$85.11	$204.17
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $43.65 / $69.18	Professional	26	$33.11	$43.65	$69.18
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $57.54 / $144.54	Professional	TC	$10.47	$57.54	$144.54
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $104.71 / $295.12	Professional		$45.71	$104.71	$295.12
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $52.48 / $89.13	Professional	26	$33.88	$52.48	$89.13
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $10.23 / $66.07 / $204.17	Professional	TC	$10.23	$66.07	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $112.20 / $158.49	Professional		$60.26	$112.20	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $46.77 / $63.10	Professional	26	$38.02	$46.77	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $57.54 / $109.65	Professional	TC	$11.22	$57.54	$109.65