Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
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 $204.17 / $257.04 / $524.81	Professional		$204.17	$257.04	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.02 / $134.90	Professional	26	$30.90	$38.02	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $223.87 / $467.74	Professional	TC	$165.96	$223.87	$467.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $19.05 / $19.95	Professional	26	$17.38	$19.05	$19.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $125.89 / $416.87	Professional		$44.67	$125.89	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $457.09	Professional		$114.82	$162.18	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $24.55 / $67.61	Professional	26	$19.05	$24.55	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $144.54 / $398.11	Professional	TC	$89.13	$144.54	$398.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $398.11 / $912.01	Professional		$295.12	$398.11	$912.01
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $58.88 / $141.25	Professional	26	$40.74	$58.88	$141.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $316.23 / $588.84	Professional	TC	$223.87	$316.23	$588.84
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 $194.98 / $269.15 / $512.86	Professional		$194.98	$269.15	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $45.71 / $70.79	Professional	26	$28.18	$45.71	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $229.09 / $457.09	Professional	TC	$147.91	$229.09	$457.09