Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.20 / $74.20 / $74.20	Facility	26	$74.20	$74.20	$74.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.06 / $97.33 / $226.03	Professional		$83.06	$97.33	$226.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.02 / $27.76 / $54.54	Professional	26	$25.02	$27.76	$54.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.04 / $69.72 / $174.65	Professional	TC	$58.04	$69.72	$174.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.32 / $124.32 / $124.32	Professional		$124.32	$124.32	$124.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.00 / $37.00 / $37.00	Professional	26	$37.00	$37.00	$37.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.17 / $109.79 / $169.89	Professional		$35.17	$109.79	$169.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.50 / $111.10 / $193.65	Professional		$49.50	$111.10	$193.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.27 / $33.29 / $59.30	Professional	26	$15.27	$33.29	$59.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.22 / $73.69 / $134.50	Professional	TC	$34.22	$73.69	$134.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $118.80 / $174.06 / $619.79	Professional		$118.80	$174.06	$619.79
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.88 / $53.46 / $305.13	Professional	26	$34.88	$53.46	$305.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $78.62 / $119.79 / $393.75	Professional	TC	$78.62	$119.79	$393.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $43.13 / $159.91	Professional		$32.34	$43.13	$159.91
United Facility/Professional Professional Modifier Low / Median / High Price $69.08 / $123.03 / $278.77	Professional		$69.08	$123.03	$278.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.98 / $38.51 / $65.94	Professional	26	$21.98	$38.51	$65.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.69 / $86.15 / $208.82	Professional	TC	$49.69	$86.15	$208.82