Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $276.92 / $759.75 / $1,383.20	Facility		$276.92	$759.75	$1,383.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.64 / $92.64 / $92.64	Facility	26	$92.64	$92.64	$92.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.47 / $107.82 / $196.91	Professional		$86.47	$107.82	$196.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.42 / $50.77 / $213.31	Professional	26	$34.42	$50.77	$213.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.40 / $66.56 / $139.18	Professional	TC	$55.40	$66.56	$139.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $55.32 / $84.90 / $135.84	Professional		$55.32	$84.90	$135.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $18.92 / $43.47	Professional	26	$17.82	$18.92	$43.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $36.22 / $56.03	Professional	TC	$36.22	$36.22	$56.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.91 / $119.82 / $185.40	Professional		$43.91	$119.82	$185.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.02 / $64.23 / $197.08	Professional		$54.02	$64.23	$197.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.98 / $29.81 / $76.54	Professional	26	$18.98	$29.81	$76.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.97 / $39.51 / $129.93	Professional	TC	$25.97	$39.51	$129.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $123.20 / $189.07 / $330.16	Professional		$123.20	$189.07	$330.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.55 / $66.45 / $310.66	Professional	26	$43.55	$66.45	$310.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.08 / $112.71 / $310.66	Professional	TC	$77.08	$112.71	$310.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $53.84 / $173.96	Professional		$32.34	$53.84	$173.96
United Facility/Professional Professional Modifier Low / Median / High Price $79.23 / $127.25 / $181.14	Professional		$79.23	$127.25	$181.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.09 / $46.95 / $68.39	Professional	26	$27.09	$46.95	$68.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.15 / $75.73 / $124.99	Professional	TC	$52.15	$75.73	$124.99