Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.65 / $138.65 / $138.65	Facility	26	$138.65	$138.65	$138.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.04 / $81.56 / $155.97	Professional		$69.04	$81.56	$155.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.04 / $52.91 / $117.08	Professional	26	$46.04	$52.91	$117.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.00 / $29.62 / $54.06	Professional	TC	$23.00	$29.62	$54.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.34 / $104.34 / $104.34	Professional		$104.34	$104.34	$104.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.06 / $29.84 / $64.61	Professional	26	$28.06	$29.84	$64.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.70 / $97.00 / $144.85	Professional		$65.70	$97.00	$144.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.20 / $49.13 / $151.65	Professional		$42.20	$49.13	$151.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.26 / $32.99 / $99.07	Professional	26	$28.26	$32.99	$99.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.37 / $17.30 / $52.58	Professional	TC	$12.37	$17.30	$52.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $99.75 / $147.72 / $265.98	Professional		$99.75	$147.72	$265.98
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $90.67 / $183.90	Professional	26	$62.17	$90.67	$183.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.67 / $44.61 / $81.55	Professional	TC	$30.67	$44.61	$81.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $133.30	Professional		$32.34	$32.34	$133.30
United Facility/Professional Professional Modifier Low / Median / High Price $57.15 / $95.25 / $141.08	Professional		$57.15	$95.25	$141.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.31 / $64.63 / $97.98	Professional	26	$40.31	$64.63	$97.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.84 / $28.46 / $45.40	Professional	TC	$16.84	$28.46	$45.40