Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $117.49 / $117.49	Facility	26	$117.49	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $295.12 / $457.09	Professional		$239.88	$295.12	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $104.71 / $162.18	Professional	26	$89.13	$104.71	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $186.21 / $309.03	Professional	TC	$144.54	$186.21	$309.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $436.52 / $467.74	Professional		$288.40	$436.52	$467.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	26	$158.49	$158.49	$158.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $112.20 / $162.18	Facility	26	$24.55	$112.20	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $416.87 / $1,202.26	Professional		$257.04	$416.87	$1,202.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $138.04 / $398.11	Professional	26	$87.10	$138.04	$398.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $269.15 / $794.33	Professional	TC	$151.36	$269.15	$794.33
Health Alliance Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $245.47 / $288.40	Facility	26	$97.72	$245.47	$288.40
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $346.74 / $524.81	Professional		$245.47	$346.74	$524.81
Health Alliance Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $109.65 / $154.88	Professional	26	$93.33	$109.65	$154.88
Health Alliance Plan Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $234.42 / $371.54	Professional	TC	$151.36	$234.42	$371.54
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $112.20 / $162.18	Facility	26	$24.55	$112.20	$162.18
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $346.74 / $1,202.26	Professional		$194.98	$346.74	$1,202.26
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $138.04 / $398.11	Professional	26	$81.28	$138.04	$398.11
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $234.42 / $794.33	Professional	TC	$114.82	$234.42	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $309.03 / $512.86	Professional		$223.87	$309.03	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $117.49 / $165.96	Professional	26	$95.50	$117.49	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $190.55 / $371.54	Professional	TC	$134.90	$190.55	$371.54