Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.84 / $433.65 / $967.87	Facility		$223.84	$433.65	$967.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.58 / $63.58 / $63.58	Facility	26	$63.58	$63.58	$63.58
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $160.29 / $160.29 / $160.29	Facility	TC	$160.29	$160.29	$160.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.78 / $73.65 / $294.42	Professional		$59.78	$73.65	$294.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.66 / $35.36 / $314.60	Professional	26	$20.66	$35.36	$314.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.00 / $50.23 / $110.17	Professional	TC	$41.00	$50.23	$110.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.83 / $48.70 / $86.89	Professional		$43.83	$48.70	$86.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $17.07 / $31.52	Professional	26	$12.86	$17.07	$31.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $31.58 / $31.58 / $48.96	Professional	TC	$31.58	$31.58	$48.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.24 / $96.49 / $149.30	Professional		$29.24	$96.49	$149.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.99 / $47.83 / $153.06	Professional		$33.99	$47.83	$153.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.13 / $13.90 / $44.82	Professional	26	$11.13	$13.90	$44.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.06 / $34.25 / $109.60	Professional	TC	$23.06	$34.25	$109.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.40 / $147.90 / $241.13	Professional		$104.40	$147.90	$241.13
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.89 / $44.13 / $132.26	Professional	26	$29.89	$44.13	$132.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.96 / $91.16 / $174.40	Professional	TC	$61.96	$91.16	$174.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.17 / $39.92 / $102.75	Professional		$18.17	$39.92	$102.75
United Facility/Professional Professional Modifier Low / Median / High Price $58.54 / $79.62 / $132.69	Professional		$58.54	$79.62	$132.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.27 / $24.85 / $43.37	Professional	26	$18.27	$24.85	$43.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.75 / $58.59 / $94.08	Professional	TC	$39.75	$58.59	$94.08