Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.56 / $76.56 / $76.56	Facility	26	$76.56	$76.56	$76.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.98 / $104.52 / $193.90	Professional		$88.98	$104.52	$193.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.70 / $27.42 / $56.74	Professional	26	$24.70	$27.42	$56.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.28 / $77.18 / $133.18	Professional	TC	$64.28	$77.18	$133.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $148.94 / $148.94 / $148.94	Professional		$148.94	$148.94	$148.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.69 / $18.69 / $18.69	Professional	26	$18.69	$18.69	$18.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $101.14 / $202.39	Professional		$36.29	$101.14	$202.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.99 / $65.00 / $202.79	Professional		$36.99	$65.00	$202.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.73 / $16.36 / $53.99	Professional	26	$12.73	$16.36	$53.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.49 / $48.64 / $155.63	Professional	TC	$24.49	$48.64	$155.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.53 / $200.50 / $433.70	Professional		$141.53	$200.50	$433.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.99 / $52.35 / $245.46	Professional	26	$35.99	$52.35	$245.46
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $88.32 / $137.16 / $247.67	Professional	TC	$88.32	$137.16	$247.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $191.10	Professional		$32.34	$32.34	$191.10
United Facility/Professional Professional Modifier Low / Median / High Price $67.62 / $102.46 / $164.53	Professional		$67.62	$102.46	$164.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.88 / $28.40 / $49.95	Professional	26	$20.88	$28.40	$49.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.89 / $70.25 / $117.20	Professional	TC	$47.89	$70.25	$117.20