Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.91 / $178.18 / $310.04	Facility		$95.91	$178.18	$310.04
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.94 / $42.94 / $42.94	Facility	26	$42.94	$42.94	$42.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.04 / $63.58 / $139.03	Professional		$48.04	$63.58	$139.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.36 / $66.36 / $66.36	Professional	25	$66.36	$66.36	$66.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.83 / $27.04 / $63.87	Professional	26	$20.83	$27.04	$63.87
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $216.02 / $216.02 / $216.02	Professional	50	$216.02	$216.02	$216.02
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.69 / $28.14 / $43.93	Professional	52	$23.69	$28.14	$43.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.56 / $33.56 / $62.82	Professional	TC	$26.56	$33.56	$62.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.33 / $57.35 / $57.35	Professional		$53.33	$57.35	$57.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.06 / $63.75 / $81.81	Professional		$29.06	$63.75	$81.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.10 / $84.10 / $84.10	Facility		$84.10	$84.10	$84.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.06 / $84.10 / $125.82	Professional		$53.06	$84.10	$125.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $33.11 / $54.03	Professional	26	$22.69	$33.11	$54.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.91 / $52.16 / $72.89	Professional	TC	$29.91	$52.16	$72.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $50.34 / $80.47 / $147.00	Professional		$50.34	$80.47	$147.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.96 / $33.84 / $71.77	Professional	26	$20.96	$33.84	$71.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.61 / $45.23 / $97.27	Professional	TC	$28.61	$45.23	$97.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $45.64 / $88.10	Professional		$32.34	$45.64	$88.10
United Facility/Professional Professional Modifier Low / Median / High Price $52.69 / $69.97 / $113.75	Professional		$52.69	$69.97	$113.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.54 / $27.26 / $43.12	Professional	26	$21.54	$27.26	$43.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.24 / $39.69 / $67.23	Professional	TC	$30.24	$39.69	$67.23