Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $389.05 / $389.05 / $489.78	Facility	26	$389.05	$389.05	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,230.27 / $1,905.46	Professional		$1,023.29	$1,230.27	$1,905.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $275.42 / $389.05 / $851.14	Professional	26	$275.42	$389.05	$851.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $724.44 / $870.96 / $1,318.26	Professional	TC	$724.44	$870.96	$1,318.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $275.42 / $323.59 / $549.54	Professional	26	$275.42	$323.59	$549.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,479.11 / $1,479.11	Professional		$1,047.13	$1,479.11	$1,479.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $457.09 / $457.09 / $457.09	Professional	26	$457.09	$457.09	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,479.11 / $1,949.84	Professional		$933.25	$1,479.11	$1,949.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $446.68 / $575.44	Professional	26	$263.03	$446.68	$575.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $1,071.52 / $1,445.44	Professional	TC	$660.69	$1,071.52	$1,445.44
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $371.54 / $389.05 / $977.24	Facility	26	$371.54	$389.05	$977.24
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,318.26 / $1,905.46	Professional		$1,047.13	$1,318.26	$1,905.46
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $288.40 / $389.05 / $691.83	Professional	26	$288.40	$389.05	$691.83
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $933.25 / $1,348.96	Professional	TC	$758.58	$933.25	$1,348.96
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,584.89 / $1,949.84	Professional		$933.25	$1,584.89	$1,949.84
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $457.09 / $575.44	Professional	26	$263.03	$457.09	$575.44
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $1,122.02 / $1,445.44	Professional	TC	$660.69	$1,122.02	$1,445.44
United Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,380.38 / $1,819.70	Professional		$1,071.52	$1,380.38	$1,819.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $323.59 / $407.38 / $562.34	Professional	26	$323.59	$407.38	$562.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $741.31 / $933.25 / $1,230.27	Professional	TC	$741.31	$933.25	$1,230.27