Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $261.61 / $304.85 / $508.15	Facility		$261.61	$304.85	$508.15
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.11 / $78.11 / $78.11	Facility	26	$78.11	$78.11	$78.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $183.50 / $183.50 / $183.50	Facility	TC	$183.50	$183.50	$183.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.06 / $93.12 / $240.59	Professional		$78.06	$93.12	$240.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.80 / $38.25 / $104.61	Professional	26	$26.80	$38.25	$104.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.24 / $56.80 / $121.76	Professional	TC	$47.24	$56.80	$121.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.14 / $51.14 / $101.43	Professional		$51.14	$51.14	$101.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.65 / $20.03 / $45.06	Professional	26	$15.65	$20.03	$45.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.07 / $36.07 / $66.95	Professional	TC	$36.07	$36.07	$66.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.74 / $112.80 / $174.55	Professional		$34.74	$112.80	$174.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.04 / $55.90 / $184.46	Professional		$44.04	$55.90	$184.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.97 / $22.78 / $58.81	Professional	26	$15.97	$22.78	$58.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.42 / $39.21 / $125.46	Professional	TC	$19.42	$39.21	$125.46
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.04 / $177.99 / $284.64	Professional		$114.04	$177.99	$284.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.72 / $55.90 / $237.88	Professional	26	$36.72	$55.90	$237.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $71.17 / $111.63 / $252.18	Professional	TC	$71.17	$111.63	$252.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.31 / $32.34 / $152.05	Professional		$11.31	$32.34	$152.05
United Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $107.19 / $151.27	Professional		$66.73	$107.19	$151.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.68 / $38.94 / $61.28	Professional	26	$22.68	$38.94	$61.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.06 / $67.06 / $102.67	Professional	TC	$44.06	$67.06	$102.67