Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $42.66 / $43.65	Facility	26	$30.90	$42.66	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $275.42	Professional		$87.10	$114.82	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $43.65 / $181.97	Professional	26	$23.44	$43.65	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $85.11 / $128.82	Professional	TC	$63.10	$85.11	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $15.85 / $28.18	Professional	26	$15.85	$15.85	$28.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $181.97 / $204.17	Professional		$48.98	$181.97	$204.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $52.48 / $52.48	Professional	26	$38.90	$52.48	$52.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $114.82 / $114.82	Professional	TC	$114.82	$114.82	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $66.07 / $512.86	Professional		$43.65	$66.07	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $17.78 / $125.89	Professional	26	$13.18	$17.78	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $47.86 / $213.80	Professional	TC	$30.90	$47.86	$213.80
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $50.12 / $60.26	Facility	26	$21.88	$50.12	$60.26
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $257.04	Professional		$89.13	$120.23	$257.04
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $31.62 / $109.65	Professional	26	$20.42	$31.62	$109.65
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $85.11 / $154.88	Professional	TC	$52.48	$85.11	$154.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $54.95 / $173.78	Professional		$43.65	$54.95	$173.78
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $14.13 / $42.66	Professional	26	$13.18	$14.13	$42.66
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $39.81 / $131.83	Professional	TC	$30.90	$39.81	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $97.72 / $181.97	Professional		$61.66	$97.72	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $27.54 / $46.77	Professional	26	$17.38	$27.54	$46.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $69.18 / $131.83	Professional	TC	$45.71	$69.18	$131.83