Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.42 / $77.48 / $92.21	Facility	26	$49.42	$77.48	$92.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.24 / $210.80 / $388.49	Professional		$85.24	$210.80	$388.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $58.32 / $129.60	Professional	26	$43.82	$58.32	$129.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.05 / $169.99 / $240.00	Professional	TC	$103.05	$169.99	$240.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.05 / $141.55 / $275.20	Professional		$97.05	$141.55	$275.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.42 / $46.15 / $63.59	Professional	26	$34.42	$46.15	$63.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.94 / $185.87 / $362.45	Professional		$58.94	$185.87	$362.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.49 / $63.49 / $63.49	Facility	26	$63.49	$63.49	$63.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.38 / $249.74 / $396.03	Professional		$162.38	$249.74	$396.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.17 / $64.98 / $99.64	Professional	26	$40.17	$64.98	$99.64
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $231.34 / $231.34 / $264.19	Professional	50	$231.34	$231.34	$264.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.13 / $177.68 / $297.56	Professional	TC	$112.13	$177.68	$297.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $184.39 / $293.81 / $1,234.93	Professional		$184.39	$293.81	$1,234.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.52 / $80.55 / $329.79	Professional	26	$56.52	$80.55	$329.79
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.66 / $203.23 / $997.67	Professional	TC	$131.66	$203.23	$997.67
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 $192.41 / $197.02 / $212.20	Professional		$192.41	$197.02	$212.20
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 $134.24 / $139.91 / $150.97	Professional	TC	$134.24	$139.91	$150.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $64.06 / $212.99	Professional		$32.34	$64.06	$212.99
United Facility/Professional Professional Modifier Low / Median / High Price $179.92 / $258.35 / $380.39	Professional		$179.92	$258.35	$380.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.48 / $64.45 / $102.50	Professional	26	$50.48	$64.45	$102.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.67 / $185.62 / $284.91	Professional	TC	$127.67	$185.62	$284.91