Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.88 / $84.97 / $101.39	Facility	26	$54.88	$84.97	$101.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.24 / $220.65 / $351.09	Professional		$136.24	$220.65	$351.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.78 / $59.81 / $154.69	Professional	26	$46.78	$59.81	$154.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.80 / $141.00 / $240.00	Professional	TC	$83.80	$141.00	$240.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.81 / $101.03 / $131.19	Professional		$80.81	$101.03	$131.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.14 / $50.27 / $69.75	Professional	26	$38.14	$50.27	$69.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.62 / $61.62 / $61.62	Professional	TC	$61.62	$61.62	$61.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.67 / $157.75 / $277.51	Professional		$64.67	$157.75	$277.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.37 / $66.37 / $66.37	Facility	26	$66.37	$66.37	$66.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.16 / $207.14 / $409.89	Professional		$132.16	$207.14	$409.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.17 / $69.76 / $104.46	Professional	26	$43.17	$69.76	$104.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.45 / $132.80 / $290.67	Professional	TC	$80.45	$132.80	$290.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $153.36 / $243.68 / $1,145.13	Professional		$153.36	$243.68	$1,145.13
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.00 / $87.84 / $287.57	Professional	26	$62.00	$87.84	$287.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.76 / $146.49 / $798.27	Professional	TC	$93.76	$146.49	$798.27
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 $160.54 / $163.37 / $175.99	Professional		$160.54	$163.37	$175.99
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.23 / $63.70 / $67.17	Professional	26	$62.23	$63.70	$67.17
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.84 / $101.15 / $108.82	Professional	TC	$96.84	$101.15	$108.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $70.27 / $184.12	Professional		$32.34	$70.27	$184.12
United Facility/Professional Professional Modifier Low / Median / High Price $146.37 / $240.64 / $370.25	Professional		$146.37	$240.64	$370.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.80 / $66.70 / $111.16	Professional	26	$52.80	$66.70	$111.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.85 / $146.69 / $268.24	Professional	TC	$90.85	$146.69	$268.24