Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	26	$74.13	$74.13	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $134.90	Professional		$50.12	$58.88	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.30 / $91.20	Professional	26	$19.95	$26.30	$91.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $37.15 / $83.18	Professional	TC	$29.51	$37.15	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $15.14 / $28.18	Professional	26	$15.14	$15.14	$28.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $81.28 / $123.03	Professional		$29.51	$81.28	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $39.81 / $128.82	Professional		$33.11	$39.81	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.22 / $44.67	Professional	26	$12.88	$16.22	$44.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $26.92 / $85.11	Professional	TC	$18.20	$26.92	$85.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $120.23 / $331.13	Professional		$72.44	$120.23	$331.13
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $44.67 / $199.53	Professional	26	$28.18	$44.67	$199.53
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $72.44 / $213.80	Professional	TC	$33.11	$72.44	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $69.18 / $104.71	Professional		$43.65	$69.18	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $28.84 / $44.67	Professional	26	$18.20	$28.84	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $40.74 / $63.10	Professional	TC	$25.12	$40.74	$63.10