Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.59 / $163.59 / $163.59	Facility		$163.59	$163.59	$163.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.54 / $50.54 / $50.54	Facility	26	$50.54	$50.54	$50.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.27 / $59.14 / $111.15	Professional		$48.27	$59.14	$111.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $21.53 / $42.96	Professional	26	$17.07	$21.53	$42.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.64 / $40.04 / $74.37	Professional	TC	$31.64	$40.04	$74.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.88 / $49.88 / $49.88	Professional		$49.88	$49.88	$49.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $12.21 / $29.16	Professional	26	$10.29	$12.21	$29.16
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.27 / $34.27 / $34.27	Professional	TC	$34.27	$34.27	$34.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.96 / $70.43 / $108.98	Professional		$23.96	$70.43	$108.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.31 / $38.63 / $112.14	Professional		$31.31	$38.63	$112.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $15.06 / $37.24	Professional	26	$10.29	$15.06	$37.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $24.15 / $77.69	Professional	TC	$17.14	$24.15	$77.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $68.18 / $102.86 / $234.99	Professional		$68.18	$102.86	$234.99
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.76 / $36.61 / $155.13	Professional	26	$23.76	$36.61	$155.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.47 / $68.09 / $162.50	Professional	TC	$43.47	$68.09	$162.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.75 / $32.34 / $102.77	Professional		$31.75	$32.34	$102.77
United Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $66.79 / $94.74	Professional		$39.46	$66.79	$94.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.53 / $24.21 / $40.82	Professional	26	$14.53	$24.21	$40.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.93 / $41.55 / $65.65	Professional	TC	$24.93	$41.55	$65.65