Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.06 / $199.06 / $199.06	Facility	26	$199.06	$199.06	$199.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.49 / $99.20 / $198.09	Professional		$85.49	$99.20	$198.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.37 / $72.42 / $147.38	Professional	26	$65.37	$72.42	$147.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.12 / $25.59 / $78.67	Professional	TC	$20.12	$25.59	$78.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.36 / $85.36 / $99.32	Professional	26	$85.36	$85.36	$99.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.34 / $127.73 / $185.90	Professional		$94.34	$127.73	$185.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.16 / $75.52 / $202.57	Professional		$54.16	$75.52	$202.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.43 / $44.58 / $143.35	Professional	26	$39.43	$44.58	$143.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.35 / $23.70 / $70.67	Professional	TC	$13.35	$23.70	$70.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $129.97 / $186.42 / $400.78	Professional		$129.97	$186.42	$400.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.93 / $138.75 / $458.91	Professional	26	$97.93	$138.75	$458.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.04 / $48.33 / $458.91	Professional	TC	$32.04	$48.33	$458.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $40.94 / $169.30	Professional		$32.34	$40.94	$169.30
United Facility/Professional Professional Modifier Low / Median / High Price $72.70 / $128.46 / $211.35	Professional		$72.70	$128.46	$211.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.88 / $90.82 / $155.19	Professional	26	$55.88	$90.82	$155.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.82 / $29.37 / $61.38	Professional	TC	$16.82	$29.37	$61.38