Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $93.33 / $117.49	Facility	26	$93.33	$93.33	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $446.68 / $645.65	Professional		$338.84	$446.68	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $93.33 / $263.03	Professional	26	$67.61	$93.33	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $363.08 / $537.03	Professional	TC	$275.42	$363.08	$537.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $69.18 / $117.49	Professional	26	$67.61	$69.18	$117.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $575.44 / $616.60	Professional		$549.54	$575.44	$616.60
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $114.82 / $114.82	Professional	26	$114.82	$114.82	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $389.05 / $891.25	Professional		$316.23	$389.05	$891.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $85.11 / $165.96	Professional	26	$51.29	$85.11	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $323.59 / $741.31	Professional	TC	$263.03	$323.59	$741.31
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $93.33 / $117.49	Facility	26	$89.13	$93.33	$117.49
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $407.38 / $724.44	Professional		$61.66	$407.38	$724.44
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $93.33 / $208.93	Professional	26	$69.18	$93.33	$208.93
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $398.11 / $691.83	Professional	TC	$288.40	$398.11	$691.83
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $380.19 / $831.76	Professional		$275.42	$380.19	$831.76
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $85.11 / $165.96	Professional	26	$51.29	$85.11	$165.96
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $323.59 / $1,174.90	Professional	TC	$223.87	$323.59	$1,174.90
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $426.58 / $616.60	Professional		$346.74	$426.58	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $87.10 / $112.20	Professional	26	$74.13	$87.10	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $346.74 / $501.19	Professional	TC	$275.42	$346.74	$501.19