Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $27.54 / $34.67	Facility	26	$27.54	$27.54	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $229.09 / $338.84	Professional		$186.21	$229.09	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.92 / $85.11	Professional	26	$19.05	$26.92	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $208.93 / $346.74	Professional	TC	$162.18	$208.93	$346.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $29.51 / $38.90	Professional	26	$19.50	$29.51	$38.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $316.23 / $338.84	Professional		$302.00	$316.23	$338.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $37.15 / $37.15	Professional	26	$37.15	$37.15	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $257.04 / $537.03	Professional		$169.82	$257.04	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $27.54 / $51.29	Professional	26	$16.22	$27.54	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $229.09 / $489.78	Professional	TC	$154.88	$229.09	$489.78
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $27.54 / $57.54	Facility	26	$26.92	$27.54	$57.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $245.47 / $398.11	Professional		$186.21	$245.47	$398.11
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.92 / $53.70	Professional	26	$19.50	$26.92	$53.70
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $218.78 / $354.81	Professional	TC	$165.96	$218.78	$354.81
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $257.04 / $537.03	Professional		$169.82	$257.04	$537.03
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $27.54 / $51.29	Professional	26	$16.22	$27.54	$51.29
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $229.09 / $489.78	Professional	TC	$154.88	$229.09	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $263.03 / $354.81	Professional		$218.78	$263.03	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $26.92 / $34.67	Professional	26	$22.91	$26.92	$34.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $234.42 / $316.23	Professional	TC	$199.53	$234.42	$316.23