Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.79 / $256.10 / $265.20	Facility		$78.79	$256.10	$265.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.07 / $16.07 / $16.07	Facility	26	$16.07	$16.07	$16.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.76 / $34.79 / $64.75	Professional		$23.76	$34.79	$64.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.40 / $6.69 / $16.30	Professional	26	$5.40	$6.69	$16.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $28.50 / $62.69	Professional	TC	$18.68	$28.50	$62.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $17.03 / $37.86	Professional		$13.00	$17.03	$37.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.10 / $3.69 / $7.64	Professional	26	$3.10	$3.69	$7.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.10 / $47.10 / $47.10	Facility		$47.10	$47.10	$47.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.62 / $21.24 / $51.78	Professional		$7.62	$21.24	$51.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.09 / $22.26 / $55.35	Professional		$15.09	$22.26	$55.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.21 / $3.74 / $11.34	Professional	26	$3.21	$3.74	$11.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.88 / $17.14 / $44.83	Professional	TC	$11.88	$17.14	$44.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.20 / $52.80 / $141.44	Professional		$36.20	$52.80	$141.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $11.24 / $57.66	Professional	26	$7.56	$11.24	$57.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.50 / $41.58 / $96.78	Professional	TC	$28.50	$41.58	$96.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.10 / $32.34 / $49.49	Professional		$10.10	$32.34	$49.49
United Facility/Professional Professional Modifier Low / Median / High Price $19.86 / $34.43 / $59.27	Professional		$19.86	$34.43	$59.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.59 / $7.07 / $10.67	Professional	26	$4.59	$7.07	$10.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.26 / $26.44 / $52.22	Professional	TC	$15.26	$26.44	$52.22