Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $23.44 / $23.44	Facility	26	$23.44	$23.44	$23.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $213.80	Professional		$97.72	$123.03	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.14 / $19.95	Professional	26	$12.88	$15.14	$19.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $104.71 / $147.91	Professional	TC	$83.18	$104.71	$147.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $154.88	Professional		$120.23	$120.23	$154.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $53.70 / $151.36	Professional		$16.22	$53.70	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $134.90 / $218.78	Professional		$85.11	$134.90	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $18.20 / $28.18	Professional	26	$12.30	$18.20	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $125.89 / $204.17	Professional	TC	$79.43	$125.89	$204.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $162.18 / $275.42	Professional		$85.11	$162.18	$275.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $19.95 / $51.29	Professional	26	$11.75	$19.95	$51.29
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $141.25 / $213.80	Professional	TC	$69.18	$141.25	$213.80
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 $83.18 / $107.15 / $181.97	Professional		$83.18	$107.15	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $15.14 / $25.70	Professional	26	$12.30	$15.14	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $91.20 / $154.88	Professional	TC	$69.18	$91.20	$154.88