Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.38 / $80.38 / $80.38	Facility	26	$80.38	$80.38	$80.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.40 / $130.04 / $228.03	Professional		$89.40	$130.04	$228.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.32 / $35.13 / $76.00	Professional	26	$27.32	$35.13	$76.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.27 / $97.19 / $155.66	Professional	TC	$54.27	$97.19	$155.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.83 / $65.83 / $164.45	Professional		$65.83	$65.83	$164.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.46 / $30.92 / $46.37	Professional	26	$15.46	$30.92	$46.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.10 / $125.09 / $223.60	Professional		$38.10	$125.09	$223.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.24 / $75.41 / $224.43	Professional		$47.24	$75.41	$224.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.47 / $22.97 / $60.55	Professional	26	$16.47	$22.97	$60.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.35 / $54.84 / $175.22	Professional	TC	$22.35	$54.84	$175.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $132.91 / $194.21 / $360.08	Professional		$132.91	$194.21	$360.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.79 / $57.65 / $125.10	Professional	26	$37.79	$57.65	$125.10
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $68.15 / $142.36 / $293.27	Professional	TC	$68.15	$142.36	$293.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $46.72 / $211.47	Professional		$32.34	$46.72	$211.47
United Facility/Professional Professional Modifier Low / Median / High Price $79.98 / $108.84 / $182.77	Professional		$79.98	$108.84	$182.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.11 / $39.57 / $66.09	Professional	26	$23.11	$39.57	$66.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.87 / $68.20 / $109.14	Professional	TC	$56.87	$68.20	$109.14