Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.93 / $362.70 / $781.20	Facility		$78.93	$362.70	$781.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.47 / $83.47 / $83.47	Facility	26	$83.47	$83.47	$83.47
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $83.61 / $83.61 / $83.61	Facility	TC	$83.61	$83.61	$83.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.49 / $93.23 / $470.29	Professional		$58.49	$93.23	$470.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.75 / $46.12 / $282.83	Professional	26	$30.75	$46.12	$282.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.31 / $30.43 / $58.79	Professional	52	$26.31	$30.43	$58.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.75 / $46.67 / $522.23	Professional	TC	$27.75	$46.67	$522.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.50 / $32.65 / $65.54	Professional		$32.50	$32.65	$65.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.10 / $18.03 / $45.62	Professional	26	$16.10	$18.03	$45.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.39 / $16.39 / $33.71	Professional	TC	$16.39	$16.39	$33.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.56 / $73.04 / $128.07	Professional		$39.56	$73.04	$128.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.93 / $56.43 / $120.10	Professional		$32.93	$56.43	$120.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $20.36 / $59.77	Professional	26	$17.07	$20.36	$59.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.86 / $29.71 / $60.33	Professional	TC	$15.86	$29.71	$60.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $79.03 / $119.21 / $256.39	Professional		$79.03	$119.21	$256.39
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.24 / $59.76 / $223.22	Professional	26	$39.24	$59.76	$223.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.89 / $55.96 / $241.43	Professional	TC	$34.89	$55.96	$241.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.23 / $32.34 / $97.10	Professional		$11.23	$32.34	$97.10
United Facility/Professional Professional Modifier Low / Median / High Price $44.43 / $77.01 / $122.28	Professional		$44.43	$77.01	$122.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.22 / $39.02 / $57.62	Professional	26	$24.22	$39.02	$57.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $35.39 / $74.17	Professional	TC	$20.21	$35.39	$74.17