Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.13 / $40.13 / $193.05	Facility		$40.13	$40.13	$193.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $10.72 / $10.72	Facility	26	$10.72	$10.72	$10.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.63 / $15.61 / $30.48	Professional		$11.63	$15.61	$30.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.66 / $4.41 / $11.03	Professional	26	$3.66	$4.41	$11.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.36 / $11.26 / $25.85	Professional	TC	$8.36	$11.26	$25.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $1.97 / $2.29 / $6.18	Professional	26	$1.97	$2.29	$6.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $8.72 / $8.72 / $8.72	Professional	TC	$8.72	$8.72	$8.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.57 / $44.57 / $44.57	Facility		$44.57	$44.57	$44.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.08 / $15.64 / $26.22	Professional		$5.08	$15.64	$26.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.64 / $10.76 / $27.44	Professional		$7.64	$10.76	$27.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.11 / $2.47 / $7.33	Professional	26	$2.11	$2.47	$7.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.47 / $7.44 / $20.68	Professional	TC	$5.47	$7.44	$20.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $18.34 / $27.44 / $71.51	Professional		$18.34	$27.44	$71.51
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.93 / $7.33 / $39.96	Professional	26	$4.93	$7.33	$39.96
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.50 / $19.37 / $75.36	Professional	TC	$12.50	$19.37	$75.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.73 / $25.73 / $32.34	Professional		$6.73	$25.73	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $10.22 / $17.54 / $30.33	Professional		$10.22	$17.54	$30.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.06 / $4.88 / $7.04	Professional	26	$3.06	$4.88	$7.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $7.16 / $12.29 / $25.39	Professional	TC	$7.16	$12.29	$25.39