Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $57.54 / $58.88	Facility	26	$57.54	$57.54	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $407.38	Professional		$128.82	$169.82	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $57.54 / $190.55	Professional	26	$39.81	$57.54	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $112.20 / $245.47	Professional	TC	$85.11	$112.20	$245.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $54.95 / $63.10	Professional	26	$54.95	$54.95	$63.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $213.80	Professional		$138.04	$199.53	$213.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	26	$67.61	$67.61	$67.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $48.98 / $70.79	Facility	26	$10.47	$48.98	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $194.98 / $426.58	Professional		$131.83	$194.98	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $61.66 / $131.83	Professional	26	$44.67	$61.66	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $131.83 / $295.12	Professional	TC	$93.33	$131.83	$295.12
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $58.88 / $131.83	Facility	26	$57.54	$58.88	$131.83
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $331.13	Professional		$128.82	$169.82	$331.13
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $57.54 / $109.65	Professional	26	$42.66	$57.54	$109.65
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $112.20 / $213.80	Professional	TC	$83.18	$112.20	$213.80
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $48.98 / $70.79	Facility	26	$10.47	$48.98	$70.79
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $177.83 / $288.40	Professional		$107.15	$177.83	$288.40
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $56.23 / $95.50	Professional	26	$42.66	$56.23	$95.50
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $120.23 / $204.17	Professional	TC	$87.10	$120.23	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $165.96 / $269.15	Professional		$131.83	$165.96	$269.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $53.70 / $75.86	Professional	26	$43.65	$53.70	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $107.15 / $190.55	Professional	TC	$87.10	$107.15	$190.55