Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $191.69 / $249.90 / $938.86	Facility		$191.69	$249.90	$938.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.57 / $27.57 / $27.57	Facility	26	$27.57	$27.57	$27.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $164.13 / $164.13 / $164.13	Facility	TC	$164.13	$164.13	$164.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.06 / $73.91 / $154.29	Professional		$59.06	$73.91	$154.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.76 / $13.55 / $55.75	Professional	26	$9.76	$13.55	$55.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $60.25 / $101.18	Professional	TC	$50.12	$60.25	$101.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.53 / $39.72 / $84.15	Professional		$37.53	$39.72	$84.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.27 / $10.07 / $13.43	Professional	26	$5.27	$10.07	$13.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.26 / $32.26 / $59.86	Professional	TC	$32.26	$32.26	$59.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.06 / $42.39 / $126.23	Professional		$13.06	$42.39	$126.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.10 / $40.96 / $131.08	Professional		$29.10	$40.96	$131.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.58 / $6.44 / $18.85	Professional	26	$5.58	$6.44	$18.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.02 / $35.07 / $115.74	Professional	TC	$22.02	$35.07	$115.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $80.92 / $125.05 / $219.38	Professional		$80.92	$125.05	$219.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $19.34 / $77.05	Professional	26	$12.96	$19.34	$77.05
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.28 / $94.69 / $187.83	Professional	TC	$58.28	$94.69	$187.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.19 / $32.34 / $111.41	Professional		$13.19	$32.34	$111.41
United Facility/Professional Professional Modifier Low / Median / High Price $48.36 / $76.91 / $115.85	Professional		$48.36	$76.91	$115.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $12.58 / $19.72	Professional	26	$7.90	$12.58	$19.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.46 / $64.59 / $105.56	Professional	TC	$40.46	$64.59	$105.56