Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	26	$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $131.83	Professional		$52.48	$64.57	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $21.88 / $64.57	Professional	26	$18.20	$21.88	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $42.66 / $91.20	Professional	TC	$30.20	$42.66	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Professional	26	$12.30	$12.30	$12.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $77.62 / $128.82	Professional		$27.54	$77.62	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $41.69 / $131.83	Professional		$33.88	$41.69	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $14.45 / $40.74	Professional	26	$11.75	$14.45	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $29.51 / $93.33	Professional	TC	$20.42	$29.51	$93.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $112.20 / $158.49	Professional		$75.86	$112.20	$158.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $41.69 / $91.20	Professional	26	$28.18	$41.69	$91.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $67.61 / $107.15	Professional	TC	$19.05	$67.61	$107.15
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 $45.71 / $66.07 / $107.15	Professional		$45.71	$66.07	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $26.30 / $41.69	Professional	26	$16.60	$26.30	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $36.31 / $67.61	Professional	TC	$28.84	$36.31	$67.61