Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.08 / $65.08 / $65.08	Facility	26	$65.08	$65.08	$65.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.95 / $99.72 / $154.57	Professional		$63.95	$99.72	$154.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.55 / $25.17 / $287.83	Professional	26	$21.55	$25.17	$287.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.25 / $75.75 / $117.41	Professional	TC	$39.25	$75.75	$117.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.29 / $50.29 / $125.75	Professional		$50.29	$50.29	$125.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.52 / $25.03 / $37.54	Professional	26	$12.52	$25.03	$37.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.84 / $85.97 / $170.97	Professional		$30.84	$85.97	$170.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.09 / $56.06 / $175.79	Professional		$36.09	$56.06	$175.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.31 / $14.98 / $46.17	Professional	26	$13.31	$14.98	$46.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.81 / $41.03 / $128.01	Professional	TC	$21.81	$41.03	$128.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $119.56 / $168.49 / $324.73	Professional		$119.56	$168.49	$324.73
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.27 / $42.59 / $110.18	Professional	26	$29.27	$42.59	$110.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.64 / $110.78 / $208.92	Professional	TC	$79.64	$110.78	$208.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $37.82 / $161.51	Professional		$32.34	$37.82	$161.51
United Facility/Professional Professional Modifier Low / Median / High Price $58.71 / $81.00 / $133.08	Professional		$58.71	$81.00	$133.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.70 / $30.36 / $50.07	Professional	26	$18.70	$30.36	$50.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.83 / $51.52 / $90.68	Professional	TC	$38.83	$51.52	$90.68