Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.77 / $52.77 / $52.77	Facility	26	$52.77	$52.77	$52.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.57 / $173.71 / $304.94	Professional		$145.57	$173.71	$304.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $19.80 / $47.73	Professional	26	$17.80	$19.80	$47.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $127.76 / $154.01 / $266.93	Professional	TC	$127.76	$154.01	$266.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.99 / $88.99 / $88.99	Professional		$88.99	$88.99	$88.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.44 / $30.44 / $30.44	Professional	26	$30.44	$30.44	$30.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.01 / $175.44 / $299.04	Professional		$25.01	$175.44	$299.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.13 / $112.09 / $320.52	Professional		$87.13	$112.09	$320.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.86 / $26.92 / $42.17	Professional	26	$10.86	$26.92	$42.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.41 / $89.75 / $274.73	Professional	TC	$71.41	$89.75	$274.73
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $209.10 / $281.66 / $529.21	Professional		$209.10	$281.66	$529.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.89 / $34.75 / $118.52	Professional	26	$23.89	$34.75	$118.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $167.78 / $242.10 / $437.15	Professional	TC	$167.78	$242.10	$437.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $285.55	Professional		$32.34	$32.34	$285.55
United Facility/Professional Professional Modifier Low / Median / High Price $114.47 / $182.97 / $286.23	Professional		$114.47	$182.97	$286.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.04 / $32.99 / $76.08	Professional	26	$16.04	$32.99	$76.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.43 / $149.81 / $223.11	Professional	TC	$98.43	$149.81	$223.11