Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.54 / $66.66 / $145.53	Facility	26	$42.54	$66.66	$145.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.87 / $179.16 / $591.58	Professional		$111.87	$179.16	$591.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.22 / $56.17 / $192.10	Professional	26	$37.22	$56.17	$192.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.25 / $117.24 / $240.00	Professional	TC	$69.25	$117.24	$240.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.72 / $98.64 / $127.87	Professional		$76.72	$98.64	$127.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.20 / $38.38 / $54.76	Professional	26	$29.20	$38.38	$54.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.75 / $126.53 / $242.56	Professional		$50.75	$126.53	$242.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.80 / $51.80 / $51.80	Facility	26	$51.80	$51.80	$51.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.10 / $169.59 / $331.86	Professional		$106.10	$169.59	$331.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.77 / $55.57 / $83.78	Professional	26	$33.77	$55.57	$83.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.48 / $106.33 / $234.84	Professional	TC	$65.48	$106.33	$234.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $123.81 / $198.10 / $872.24	Professional		$123.81	$198.10	$872.24
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.67 / $69.17 / $313.35	Professional	26	$48.67	$69.17	$313.35
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.31 / $115.87 / $670.41	Professional	TC	$75.31	$115.87	$670.41
Hally Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $128.77 / $131.01 / $141.32	Professional		$128.77	$131.01	$141.32
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.78 / $49.96 / $52.73	Professional	26	$48.78	$49.96	$52.73
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $78.81 / $82.24 / $88.61	Professional	TC	$78.81	$82.24	$88.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $55.16 / $147.85	Professional		$32.34	$55.16	$147.85
United Facility/Professional Professional Modifier Low / Median / High Price $116.74 / $193.26 / $294.06	Professional		$116.74	$193.26	$294.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.52 / $53.21 / $109.50	Professional	26	$41.52	$53.21	$109.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.97 / $117.70 / $208.55	Professional	TC	$72.97	$117.70	$208.55