Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.92 / $44.48 / $46.24	Facility	26	$25.92	$44.48	$46.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.57 / $121.55 / $219.82	Professional		$97.57	$121.55	$219.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.41 / $25.92 / $52.11	Professional	26	$22.41	$25.92	$52.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.93 / $91.88 / $175.85	Professional	TC	$73.93	$91.88	$175.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.21 / $93.21 / $124.99	Professional		$93.21	$93.21	$124.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.32 / $25.38 / $29.76	Professional	26	$20.32	$25.38	$29.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.99 / $107.12 / $262.04	Professional		$33.99	$107.12	$262.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.23 / $156.86 / $241.98	Professional		$98.23	$156.86	$241.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.64 / $36.65 / $56.94	Professional	26	$22.64	$36.65	$56.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.27 / $122.57 / $191.19	Professional	TC	$75.27	$122.57	$191.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $142.34 / $207.04 / $468.29	Professional		$142.34	$207.04	$468.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.59 / $46.06 / $134.56	Professional	26	$32.59	$46.06	$134.56
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.46 / $163.58 / $344.32	Professional	TC	$112.46	$163.58	$344.32
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 $151.58 / $156.07 / $168.22	Professional		$151.58	$156.07	$168.22
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.38 / $33.27 / $35.31	Professional	26	$32.38	$33.27	$35.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $118.31 / $123.68 / $132.91	Professional	TC	$118.31	$123.68	$132.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $36.94 / $175.98	Professional		$32.34	$36.94	$175.98
United Facility/Professional Professional Modifier Low / Median / High Price $108.60 / $140.69 / $217.10	Professional		$108.60	$140.69	$217.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.83 / $34.07 / $53.00	Professional	26	$26.83	$34.07	$53.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.54 / $113.03 / $181.74	Professional	TC	$78.54	$113.03	$181.74