Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $66.07 / $66.07	Facility	26	$66.07	$66.07	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $331.13 / $478.63	Professional		$269.15	$331.13	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $57.54 / $123.03	Professional	26	$43.65	$57.54	$123.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $281.84 / $478.63	Professional	TC	$223.87	$281.84	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $52.48 / $89.13	Professional	26	$52.48	$52.48	$89.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $467.74 / $501.19	Professional		$389.05	$467.74	$501.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $87.10 / $87.10	Professional	26	$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $380.19 / $794.33	Professional		$251.19	$380.19	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $66.07 / $123.03	Professional	26	$38.90	$66.07	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $316.23 / $676.08	Professional	TC	$208.93	$316.23	$676.08
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $114.82 / $138.04	Facility	26	$50.12	$114.82	$138.04
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $575.44	Professional		$275.42	$346.74	$575.44
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $61.66 / $95.50	Professional	26	$46.77	$61.66	$95.50
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $295.12 / $478.63	Professional	TC	$229.09	$295.12	$478.63
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $380.19 / $794.33	Professional		$251.19	$380.19	$794.33
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $66.07 / $123.03	Professional	26	$39.81	$66.07	$123.03
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $316.23 / $676.08	Professional	TC	$208.93	$316.23	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $389.05 / $524.81	Professional		$331.13	$389.05	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $64.57 / $81.28	Professional	26	$54.95	$64.57	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $323.59 / $446.68	Professional	TC	$275.42	$323.59	$446.68