Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.42 / $77.16 / $92.21	Facility	26	$49.42	$77.16	$92.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.80 / $221.75 / $382.75	Professional		$136.80	$221.75	$382.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.20 / $62.65 / $229.50	Professional	26	$45.20	$62.65	$229.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.21 / $148.06 / $231.46	Professional	TC	$86.21	$148.06	$231.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $95.13 / $125.50	Professional		$78.84	$95.13	$125.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.90 / $39.77 / $63.59	Professional	26	$33.90	$39.77	$63.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.94 / $153.83 / $270.62	Professional		$58.94	$153.83	$270.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.76 / $62.76 / $62.76	Facility	26	$62.76	$62.76	$62.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.66 / $215.37 / $426.90	Professional		$133.66	$215.37	$426.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.40 / $65.94 / $99.73	Professional	26	$40.40	$65.94	$99.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.00 / $143.02 / $320.05	Professional	TC	$84.00	$143.02	$320.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $149.90 / $237.83 / $1,284.82	Professional		$149.90	$237.83	$1,284.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.52 / $82.43 / $363.98	Professional	26	$56.52	$82.43	$363.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.48 / $146.38 / $924.51	Professional	TC	$96.48	$146.38	$924.51
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 $156.56 / $159.85 / $171.77	Professional		$156.56	$159.85	$171.77
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.10 / $58.18 / $61.23	Professional	26	$57.10	$58.18	$61.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $98.37 / $102.75 / $110.54	Professional	TC	$98.37	$102.75	$110.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $64.06 / $179.70	Professional		$32.34	$64.06	$179.70
United Facility/Professional Professional Modifier Low / Median / High Price $156.76 / $249.61 / $393.34	Professional		$156.76	$249.61	$393.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.02 / $64.45 / $104.66	Professional	26	$51.02	$64.45	$104.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.86 / $181.59 / $274.16	Professional	TC	$103.86	$181.59	$274.16