Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $269.15 / $331.13	Facility	26	$263.03	$269.15	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $512.86 / $1,096.48	Professional		$398.11	$512.86	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $275.42 / $645.65	Professional	26	$190.55	$275.42	$645.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $263.03 / $457.09	Professional	TC	$190.55	$263.03	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $467.74 / $707.95	Professional		$363.08	$467.74	$707.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $223.87 / $331.13	Professional	26	$177.83	$223.87	$331.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $724.44 / $776.25	Professional		$416.87	$724.44	$776.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	26	$338.84	$338.84	$338.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $436.52 / $436.52	Professional	TC	$436.52	$436.52	$436.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $501.19 / $1,000.00	Professional		$275.42	$501.19	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $588.84 / $1,071.52	Professional		$416.87	$588.84	$1,071.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $281.84 / $501.19	Professional	26	$190.55	$281.84	$501.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $316.23 / $645.65	Professional	TC	$223.87	$316.23	$645.65
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $275.42 / $489.78	Facility	26	$263.03	$275.42	$489.78
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $524.81 / $851.14	Professional		$389.05	$524.81	$851.14
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $263.03 / $562.34	Professional	26	$177.83	$263.03	$562.34
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $275.42 / $467.74	Professional	TC	$218.78	$275.42	$467.74
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $575.44 / $1,071.52	Professional		$407.38	$575.44	$1,071.52
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $281.84 / $501.19	Professional	26	$173.78	$281.84	$501.19
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $316.23 / $645.65	Professional	TC	$213.80	$316.23	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $562.34 / $794.33	Professional		$426.58	$562.34	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $263.03 / $363.08	Professional	26	$204.17	$263.03	$363.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $309.03 / $407.38	Professional	TC	$229.09	$309.03	$407.38