Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.38 / $96.38 / $96.38	Facility	26	$96.38	$96.38	$96.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.71 / $103.94 / $197.77	Professional		$86.71	$103.94	$197.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.75 / $37.99 / $108.23	Professional	26	$32.75	$37.99	$108.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.96 / $66.79 / $128.44	Professional	TC	$53.96	$66.79	$128.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.16 / $132.16 / $132.16	Professional		$132.16	$132.16	$132.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.77 / $41.28 / $48.18	Professional	26	$19.77	$41.28	$48.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.68 / $116.86 / $180.83	Professional		$45.68	$116.86	$180.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.69 / $77.48 / $202.33	Professional		$52.69	$77.48	$202.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.87 / $30.31 / $77.03	Professional	26	$19.87	$30.31	$77.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.82 / $46.10 / $131.33	Professional	TC	$32.82	$46.10	$131.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $122.18 / $184.16 / $696.07	Professional		$122.18	$184.16	$696.07
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.31 / $69.53 / $317.08	Professional	26	$45.31	$69.53	$317.08
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.20 / $114.87 / $465.34	Professional	TC	$72.20	$114.87	$465.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $56.02 / $169.02	Professional		$32.34	$56.02	$169.02
United Facility/Professional Professional Modifier Low / Median / High Price $80.30 / $138.69 / $218.57	Professional		$80.30	$138.69	$218.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.59 / $50.51 / $72.55	Professional	26	$28.59	$50.51	$72.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.71 / $89.47 / $117.20	Professional	TC	$51.71	$89.47	$117.20