Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $54.95 / $69.18	Facility	26	$54.95	$54.95	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $204.17	Professional		$69.18	$89.13	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $131.83	Professional	26	$38.02	$50.12	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $44.67 / $74.13	Professional	TC	$23.99	$44.67	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $93.33	Professional		$70.79	$70.79	$93.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $123.03 / $131.83	Professional		$63.10	$123.03	$131.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $64.57 / $64.57	Professional	26	$54.95	$64.57	$64.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	TC	$67.61	$67.61	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $100.00 / $295.12	Professional		$74.13	$100.00	$295.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $57.54 / $144.54	Professional	26	$40.74	$57.54	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $40.74 / $154.88	Professional	TC	$26.92	$40.74	$154.88
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $56.23 / $128.82	Facility	26	$46.77	$56.23	$128.82
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $93.33 / $158.49	Professional		$66.07	$93.33	$158.49
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $53.70 / $104.71	Professional	26	$40.74	$53.70	$104.71
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $42.66 / $69.18	Professional	TC	$22.91	$42.66	$69.18
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $100.00 / $295.12	Professional		$77.62	$100.00	$295.12
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $60.26 / $144.54	Professional	26	$40.74	$60.26	$144.54
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $42.66 / $154.88	Professional	TC	$29.51	$42.66	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $81.28 / $112.20	Professional		$67.61	$81.28	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $51.29 / $70.79	Professional	26	$41.69	$51.29	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $30.20 / $46.77	Professional	TC	$23.44	$30.20	$46.77