Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Facility	26	$123.03	$123.03	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $112.20 / $338.84	Professional		$93.33	$112.20	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $79.43 / $120.23	Professional	26	$70.79	$79.43	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.90 / $42.66	Professional	TC	$19.05	$30.90	$42.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $120.23	Professional		$87.10	$104.71	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $89.13 / $91.20	Professional	26	$89.13	$89.13	$91.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $177.83	Professional		$83.18	$114.82	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $194.98	Professional		$85.11	$123.03	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $93.33 / $144.54	Professional	26	$64.57	$93.33	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $51.29	Professional	TC	$19.95	$32.36	$51.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $177.83 / $363.08	Professional		$83.18	$177.83	$363.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $91.20 / $331.13	Professional	26	$57.54	$91.20	$331.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $32.36 / $309.03	Professional	TC	$20.89	$32.36	$309.03
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 $87.10 / $104.71 / $181.97	Professional		$87.10	$104.71	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $83.18 / $134.90	Professional	26	$66.07	$83.18	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.12 / $44.67	Professional	TC	$17.38	$25.12	$44.67