Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.37 / $30.19 / $36.22	Facility	26	$18.37	$30.19	$36.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.31 / $89.48 / $165.36	Professional		$67.31	$89.48	$165.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.67 / $19.82 / $41.85	Professional	26	$17.67	$19.82	$41.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.57 / $68.56 / $117.08	Professional	TC	$55.57	$68.56	$117.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.35 / $95.26 / $95.26	Professional		$58.35	$95.26	$95.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $24.35 / $26.52	Professional	26	$14.92	$24.35	$26.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.39 / $96.42 / $199.55	Professional		$25.39	$96.42	$199.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.94 / $118.43 / $184.55	Professional		$74.94	$118.43	$184.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.63 / $27.39 / $42.70	Professional	26	$16.63	$27.39	$42.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.76 / $93.26 / $146.62	Professional	TC	$57.76	$93.26	$146.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $103.62 / $150.82 / $364.41	Professional		$103.62	$150.82	$364.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.32 / $30.67 / $104.58	Professional	26	$22.32	$30.67	$104.58
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $76.59 / $111.68 / $234.21	Professional	TC	$76.59	$111.68	$234.21
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 $115.44 / $118.40 / $128.30	Professional		$115.44	$118.40	$128.30
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.42 / $24.36 / $26.38	Professional	26	$22.42	$24.36	$26.38
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $86.64 / $90.52 / $101.93	Professional	TC	$86.64	$90.52	$101.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.59 / $32.34 / $134.22	Professional		$27.59	$32.34	$134.22
United Facility/Professional Professional Modifier Low / Median / High Price $83.45 / $118.24 / $197.38	Professional		$83.45	$118.24	$197.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.36 / $25.84 / $39.94	Professional	26	$20.36	$25.84	$39.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.95 / $84.72 / $141.47	Professional	TC	$60.95	$84.72	$141.47