Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $758.58 / $1,096.48	Facility		$323.59	$758.58	$1,096.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $120.23 / $457.09	Professional		$79.43	$120.23	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $123.03 / $660.69	Professional	26	$34.67	$123.03	$660.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $72.44 / $204.17	Professional	TC	$50.12	$72.44	$204.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $19.95 / $53.70	Professional	26	$17.78	$19.95	$53.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $120.23 / $186.21	Professional		$43.65	$120.23	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $81.28 / $199.53	Professional		$53.70	$81.28	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $32.36 / $75.86	Professional	26	$19.05	$32.36	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $41.69 / $128.82	Professional	TC	$33.11	$41.69	$128.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $190.55 / $316.23	Professional		$123.03	$190.55	$316.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $69.18 / $309.03	Professional	26	$43.65	$69.18	$309.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $123.03 / $309.03	Professional	TC	$77.62	$123.03	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $128.82 / $190.55	Professional		$79.43	$128.82	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $47.86 / $67.61	Professional	26	$26.92	$47.86	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $74.13 / $125.89	Professional	TC	$52.48	$74.13	$125.89