Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $261.00 / $368.90 / $848.20	Facility		$261.00	$368.90	$848.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.72 / $59.72 / $59.72	Facility	26	$59.72	$59.72	$59.72
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $201.29 / $201.29 / $201.29	Facility	TC	$201.29	$201.29	$201.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.63 / $101.13 / $240.60	Professional		$81.63	$101.13	$240.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.59 / $28.65 / $68.19	Professional	26	$21.59	$28.65	$68.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.88 / $74.31 / $122.17	Professional	TC	$61.88	$74.31	$122.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.83 / $51.01 / $100.36	Professional		$47.83	$51.01	$100.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $14.51 / $29.62	Professional	26	$11.50	$14.51	$29.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.50 / $39.51 / $73.16	Professional	TC	$39.50	$39.51	$73.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.30 / $93.69 / $173.01	Professional		$28.30	$93.69	$173.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.54 / $56.09 / $178.46	Professional		$43.54	$56.09	$178.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $14.51 / $42.62	Professional	26	$12.20	$14.51	$42.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.85 / $43.05 / $141.93	Professional	TC	$27.85	$43.05	$141.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $110.90 / $161.31 / $283.98	Professional		$110.90	$161.31	$283.98
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.07 / $41.81 / $132.74	Professional	26	$28.07	$41.81	$132.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.32 / $110.79 / $219.01	Professional	TC	$63.32	$110.79	$219.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $34.71 / $151.69	Professional		$17.98	$34.71	$151.69
United Facility/Professional Professional Modifier Low / Median / High Price $66.84 / $100.38 / $150.03	Professional		$66.84	$100.38	$150.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.16 / $27.79 / $43.23	Professional	26	$17.16	$27.79	$43.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.68 / $73.48 / $115.80	Professional	TC	$49.68	$73.48	$115.80