Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.03 / $103.29 / $113.88	Facility	26	$62.03	$103.29	$113.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.62 / $282.68 / $424.83	Professional		$173.62	$282.68	$424.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $62.04 / $172.83	Professional	26	$52.78	$62.04	$172.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.66 / $217.25 / $308.41	Professional	TC	$117.66	$217.25	$308.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.82 / $54.71 / $76.88	Professional	26	$42.82	$54.71	$76.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.84 / $201.19 / $353.93	Professional		$72.84	$201.19	$353.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.65 / $75.65 / $75.65	Facility	26	$75.65	$75.65	$75.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.82 / $282.56 / $513.90	Professional		$174.82	$282.56	$513.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.25 / $78.59 / $120.61	Professional	26	$48.25	$78.59	$120.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.63 / $189.69 / $394.27	Professional	TC	$113.63	$189.69	$394.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $195.54 / $312.02 / $1,295.03	Professional		$195.54	$312.02	$1,295.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $99.22 / $473.70	Professional	26	$69.84	$99.22	$473.70
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $130.52 / $204.74 / $804.19	Professional	TC	$130.52	$204.74	$804.19
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 $204.75 / $208.56 / $225.36	Professional		$204.75	$208.56	$225.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $71.66 / $75.69	Professional	26	$69.84	$71.66	$75.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $133.08 / $138.71 / $149.68	Professional	TC	$133.08	$138.71	$149.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $79.18 / $235.76	Professional		$32.34	$79.18	$235.76
United Facility/Professional Professional Modifier Low / Median / High Price $198.15 / $314.98 / $497.70	Professional		$198.15	$314.98	$497.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.24 / $77.72 / $131.47	Professional	26	$59.24	$77.72	$131.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $136.01 / $228.76 / $376.91	Professional	TC	$136.01	$228.76	$376.91