Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $400.89 / $414.16 / $910.68	Facility		$400.89	$414.16	$910.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.53 / $86.53 / $86.53	Facility	26	$86.53	$86.53	$86.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.56 / $143.80 / $294.67	Professional		$103.56	$143.80	$294.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.17 / $35.57 / $127.63	Professional	26	$29.17	$35.57	$127.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $112.20 / $210.47	Professional	TC	$68.95	$112.20	$210.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.55 / $78.55 / $98.61	Professional		$78.55	$78.55	$98.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.70 / $18.69 / $43.09	Professional	26	$16.70	$18.69	$43.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $64.98 / $64.98 / $64.98	Professional	TC	$64.98	$64.98	$64.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.02 / $114.32 / $266.01	Professional		$41.02	$114.32	$266.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.54 / $85.66 / $274.12	Professional		$58.54	$85.66	$274.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.69 / $21.20 / $61.99	Professional	26	$17.69	$21.20	$61.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.61 / $67.17 / $221.66	Professional	TC	$38.61	$67.17	$221.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $186.01 / $270.58 / $477.20	Professional		$186.01	$270.58	$477.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.68 / $60.42 / $208.84	Professional	26	$40.68	$60.42	$208.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.59 / $190.44 / $356.33	Professional	TC	$131.59	$190.44	$356.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $50.29 / $251.84	Professional		$32.34	$50.29	$251.84
United Facility/Professional Professional Modifier Low / Median / High Price $105.06 / $149.09 / $259.49	Professional		$105.06	$149.09	$259.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.66 / $41.10 / $69.98	Professional	26	$24.66	$41.10	$69.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.45 / $92.18 / $191.65	Professional	TC	$68.45	$92.18	$191.65