Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $97.72 / $186.21	Facility		$89.13	$97.72	$186.21
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	TC	$112.20	$112.20	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $74.13 / $213.80	Professional		$48.98	$74.13	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $41.69 / $199.53	Professional	26	$19.95	$41.69	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $36.31 / $117.49	Professional	TC	$28.18	$36.31	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $40.74	Professional		$37.15	$37.15	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $36.31	Professional	26	$12.02	$15.14	$36.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $69.18 / $107.15	Professional		$29.51	$69.18	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $158.49	Facility		$141.25	$141.25	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $64.57 / $120.23	Professional		$30.90	$64.57	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $28.84 / $48.98	Professional	26	$12.59	$28.84	$48.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $30.20 / $67.61	Professional	TC	$18.20	$30.20	$67.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $107.15 / $229.09	Professional		$67.61	$107.15	$229.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $44.67 / $218.78	Professional	26	$28.18	$44.67	$218.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $69.18 / $218.78	Professional	TC	$43.65	$69.18	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.11 / $63.10	Professional		$25.70	$33.11	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $75.86 / $123.03	Professional		$42.66	$75.86	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $30.90 / $61.66	Professional	26	$17.78	$30.90	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $43.65 / $61.66	Professional	TC	$25.12	$43.65	$61.66