Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	26	$58.88	$58.88	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $190.55	Professional		$47.86	$64.57	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $26.92 / $95.50	Professional	26	$18.20	$26.92	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $38.90 / $89.13	Professional	TC	$30.90	$38.90	$89.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $20.42 / $29.51	Professional	26	$10.72	$20.42	$29.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Facility		$66.07	$66.07	$66.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $70.79 / $107.15	Professional		$23.99	$70.79	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $39.81 / $112.20	Professional		$31.62	$39.81	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.22 / $38.02	Professional	26	$10.23	$16.22	$38.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $23.99 / $77.62	Professional	TC	$19.95	$23.99	$77.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $107.15 / $263.03	Professional		$67.61	$107.15	$263.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $38.02 / $158.49	Professional	26	$22.39	$38.02	$158.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $67.61 / $162.18	Professional	TC	$38.90	$67.61	$162.18
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 $39.81 / $67.61 / $97.72	Professional		$39.81	$67.61	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $23.99 / $36.31	Professional	26	$14.45	$23.99	$36.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $43.65 / $61.66	Professional	TC	$25.12	$43.65	$61.66