Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.07 / $94.69 / $113.25	Facility	26	$61.07	$94.69	$113.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $282.06 / $423.53	Professional		$171.00	$282.06	$423.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $62.09 / $172.83	Professional	26	$52.78	$62.09	$172.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.00 / $215.99 / $307.10	Professional	TC	$117.00	$215.99	$307.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.31 / $115.31 / $115.31	Professional		$115.31	$115.31	$115.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.70 / $54.33 / $74.79	Professional	26	$42.70	$54.33	$74.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.04 / $199.86 / $351.60	Professional		$72.04	$199.86	$351.60
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 $173.67 / $275.00 / $499.31	Professional		$173.67	$275.00	$499.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.65 / $77.70 / $119.07	Professional	26	$48.65	$77.70	$119.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.98 / $188.09 / $382.62	Professional	TC	$112.98	$188.09	$382.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $194.60 / $309.67 / $1,442.93	Professional		$194.60	$309.67	$1,442.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.06 / $98.42 / $527.32	Professional	26	$69.06	$98.42	$527.32
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.77 / $203.56 / $1,063.97	Professional	TC	$129.77	$203.56	$1,063.97
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 $203.40 / $207.61 / $223.65	Professional		$203.40	$207.61	$223.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.70 / $71.08 / $74.83	Professional	26	$69.70	$71.08	$74.83
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $132.31 / $137.90 / $148.81	Professional	TC	$132.31	$137.90	$148.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $78.28 / $233.97	Professional		$32.34	$78.28	$233.97
United Facility/Professional Professional Modifier Low / Median / High Price $197.09 / $311.19 / $489.21	Professional		$197.09	$311.19	$489.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.82 / $75.81 / $122.98	Professional	26	$58.82	$75.81	$122.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.94 / $229.41 / $338.95	Professional	TC	$134.94	$229.41	$338.95