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 / $83.18	Facility	26	$66.07	$66.07	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $186.21 / $398.11	Professional		$144.54	$186.21	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $66.07 / $194.98	Professional	26	$48.98	$66.07	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $125.89 / $213.80	Professional	TC	$95.50	$125.89	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $53.70 / $77.62	Professional	26	$48.98	$53.70	$77.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $263.03 / $281.84	Professional		$83.18	$263.03	$281.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $89.13 / $89.13	Professional	26	$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $239.88 / $380.19	Professional		$147.91	$239.88	$380.19
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 $102.33 / $204.17 / $263.03	Professional	TC	$102.33	$204.17	$263.03
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $67.61 / $131.83	Facility	26	$64.57	$67.61	$131.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $194.98 / $354.81	Professional		$138.04	$194.98	$354.81
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $64.57 / $165.96	Professional	26	$45.71	$64.57	$165.96
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $128.82 / $239.88	Professional	TC	$91.20	$128.82	$239.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $186.21 / $380.19	Professional		$158.49	$186.21	$380.19
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $66.07 / $123.03	Professional	26	$38.90	$66.07	$123.03
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $204.17 / $263.03	Professional	TC	$104.71	$204.17	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $199.53 / $275.42	Professional		$162.18	$199.53	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $64.57 / $85.11	Professional	26	$54.95	$64.57	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $128.82 / $186.21	Professional	TC	$107.15	$128.82	$186.21