Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $93.33 / $93.33	Facility	26	$93.33	$93.33	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $48.98 / $138.04	Professional		$38.90	$48.98	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $60.26 / $181.97	Professional	26	$26.92	$60.26	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $18.20 / $43.65	Professional	TC	$12.88	$18.20	$43.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $16.98 / $45.71	Professional	26	$15.49	$16.98	$45.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $57.54 / $89.13	Professional		$38.02	$57.54	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.11 / $91.20	Professional		$25.70	$33.11	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $18.20 / $54.95	Professional	26	$16.22	$18.20	$54.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $12.30 / $35.48	Professional	TC	$9.33	$12.30	$35.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $89.13 / $213.80	Professional		$63.10	$89.13	$213.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $54.95 / $218.78	Professional	26	$35.48	$54.95	$218.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $34.67 / $309.03	Professional	TC	$21.38	$34.67	$309.03
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 $35.48 / $56.23 / $89.13	Professional		$35.48	$56.23	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $35.48 / $57.54	Professional	26	$22.91	$35.48	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $20.42 / $30.90	Professional	TC	$12.30	$20.42	$30.90