Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.53 / $76.78 / $100.72	Facility	26	$54.53	$76.78	$100.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.40 / $160.31 / $329.77	Professional		$134.40	$160.31	$329.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.10 / $58.94 / $246.05	Professional	26	$46.10	$58.94	$246.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.87 / $97.45 / $167.46	Professional	TC	$86.87	$97.45	$167.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.10 / $126.70 / $164.71	Professional		$94.10	$126.70	$164.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $51.35 / $70.00	Professional	26	$37.88	$51.35	$70.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.70 / $75.77 / $122.08	Professional	TC	$58.70	$75.77	$122.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.26 / $163.18 / $312.81	Professional		$64.26	$163.18	$312.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.80 / $196.48 / $291.19	Professional		$127.80	$196.48	$291.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.48 / $69.31 / $102.67	Professional	26	$42.48	$69.31	$102.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.70 / $124.42 / $184.40	Professional	TC	$80.70	$124.42	$184.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $158.38 / $238.58 / $848.63	Professional		$158.38	$238.58	$848.63
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.49 / $77.87 / $255.39	Professional	26	$56.49	$77.87	$255.39
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.90 / $133.50 / $452.48	Professional	TC	$97.90	$133.50	$452.48
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 $166.06 / $168.73 / $182.44	Professional		$166.06	$168.73	$182.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.74 / $61.80 / $66.76	Professional	26	$56.74	$61.80	$66.76
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $98.35 / $102.79 / $115.70	Professional	TC	$98.35	$102.79	$115.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $69.84 / $190.86	Professional		$32.34	$69.84	$190.86
United Facility/Professional Professional Modifier Low / Median / High Price $148.66 / $189.68 / $321.38	Professional		$148.66	$189.68	$321.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.39 / $68.00 / $109.00	Professional	26	$52.39	$68.00	$109.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.77 / $120.34 / $207.14	Professional	TC	$95.77	$120.34	$207.14