Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.32 / $93.32 / $93.32	Facility	26	$93.32	$93.32	$93.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.03 / $259.38 / $402.04	Professional		$182.03	$259.38	$402.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.98 / $36.29 / $67.36	Professional	26	$31.98	$36.29	$67.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.21 / $224.15 / $347.43	Professional	TC	$143.21	$224.15	$347.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.73 / $193.73 / $193.73	Professional		$193.73	$193.73	$193.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.95 / $19.14 / $46.64	Professional	26	$17.95	$19.14	$46.64
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $164.57 / $164.57 / $164.57	Professional	TC	$164.57	$164.57	$164.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.23 / $127.17 / $418.93	Professional		$44.23	$127.17	$418.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.29 / $155.69 / $446.88	Professional		$102.29	$155.69	$446.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.25 / $23.77 / $66.97	Professional	26	$19.25	$23.77	$66.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.92 / $126.33 / $394.07	Professional	TC	$79.92	$126.33	$394.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $292.94 / $402.20 / $915.80	Professional		$292.94	$402.20	$915.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.34 / $61.58 / $119.17	Professional	26	$42.34	$61.58	$119.17
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $227.95 / $318.14 / $601.54	Professional	TC	$227.95	$318.14	$601.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $54.24 / $398.12	Professional		$32.34	$54.24	$398.12
United Facility/Professional Professional Modifier Low / Median / High Price $183.22 / $294.95 / $487.56	Professional		$183.22	$294.95	$487.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.38 / $46.19 / $71.92	Professional	26	$28.38	$46.19	$71.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.99 / $241.66 / $440.11	Professional	TC	$147.99	$241.66	$440.11