Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $275.42	Facility		$269.15	$269.15	$275.42
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $162.18 / $162.18	Facility	26	$162.18	$162.18	$162.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	TC	$112.20	$112.20	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $302.00	Professional		$64.57	$93.33	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $173.78 / $794.33	Professional	26	$51.29	$173.78	$794.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $35.48 / $83.18	Professional	TC	$25.70	$35.48	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $29.51 / $58.88	Professional	26	$26.92	$29.51	$58.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $102.33 / $158.49	Professional		$66.07	$102.33	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $75.86 / $162.18	Professional		$45.71	$75.86	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $34.67 / $100.00	Professional	26	$28.18	$34.67	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $20.89 / $66.07	Professional	TC	$15.14	$20.89	$66.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $162.18 / $346.74	Professional		$109.65	$162.18	$346.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $97.72 / $331.13	Professional	26	$63.10	$97.72	$331.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $57.54 / $295.12	Professional	TC	$28.18	$57.54	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $97.72 / $151.36	Professional		$61.66	$97.72	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $63.10 / $100.00	Professional	26	$40.74	$63.10	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $54.95	Professional	TC	$21.88	$33.11	$54.95