Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $257.04 / $263.03	Facility		$93.33	$257.04	$263.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $18.62 / $18.62	Facility	26	$18.62	$18.62	$18.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $37.15 / $120.23	Professional		$22.91	$37.15	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $12.59 / $42.66	Professional	26	$5.01	$12.59	$42.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.91 / $54.95	Professional	TC	$15.85	$22.91	$54.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.09 / $4.17 / $7.08	Professional	26	$3.09	$4.17	$7.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $21.38 / $51.29	Professional		$7.59	$21.38	$51.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $64.57	Facility		$53.70	$53.70	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $25.12 / $54.95	Professional		$15.14	$25.12	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.24 / $3.98 / $11.22	Professional	26	$3.24	$3.98	$11.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $19.05 / $44.67	Professional	TC	$11.75	$19.05	$44.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $53.70 / $154.88	Professional		$36.31	$53.70	$154.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.22 / $95.50	Professional	26	$7.08	$11.22	$95.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $41.69 / $97.72	Professional	TC	$26.30	$41.69	$97.72
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 $19.95 / $34.67 / $58.88	Professional		$19.95	$34.67	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.57 / $7.08 / $11.48	Professional	26	$4.57	$7.08	$11.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $26.30 / $52.48	Professional	TC	$15.14	$26.30	$52.48