Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $120.23 / $144.54	Facility	26	$114.82	$120.23	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $870.96 / $1,148.15	Professional		$707.95	$870.96	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $100.00 / $281.84	Professional	26	$77.62	$100.00	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $794.33 / $1,122.02	Professional	TC	$630.96	$794.33	$1,122.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	26	$162.18	$162.18	$162.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,202.26 / $1,288.25	Professional		$1,047.13	$1,202.26	$1,288.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	26	$151.36	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,659.59 / $2,238.72	Professional		$691.83	$1,659.59	$2,238.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $114.82 / $223.87	Professional	26	$72.44	$114.82	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $776.25 / $1,479.11 / $1,995.26	Professional	TC	$776.25	$1,479.11	$1,995.26
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $199.53 / $239.88	Facility	26	$87.10	$199.53	$239.88
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $912.01 / $1,258.93	Professional		$724.44	$912.01	$1,258.93
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $107.15 / $194.98	Professional	26	$81.28	$107.15	$194.98
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $812.83 / $1,148.15	Professional	TC	$645.65	$812.83	$1,148.15
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,659.59 / $1,995.26	Professional		$660.69	$1,659.59	$1,995.26
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $114.82 / $213.80	Professional	26	$72.44	$114.82	$213.80
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $1,479.11 / $2,630.27	Professional	TC	$575.44	$1,479.11	$2,630.27
United Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,000.00 / $1,318.26	Professional		$851.14	$1,000.00	$1,318.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $112.20 / $144.54	Professional	26	$95.50	$112.20	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $870.96 / $1,174.90	Professional	TC	$758.58	$870.96	$1,174.90