Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.87 / $46.48 / $49.35	Facility	26	$26.87	$46.48	$49.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $113.77 / $215.16	Professional		$90.73	$113.77	$215.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.91 / $27.09 / $64.00	Professional	26	$23.91	$27.09	$64.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.45 / $89.11 / $151.80	Professional	TC	$66.45	$89.11	$151.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.82 / $21.82 / $21.82	Professional	26	$21.82	$21.82	$21.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.63 / $107.12 / $275.80	Professional		$35.63	$107.12	$275.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.62 / $156.26 / $233.91	Professional		$94.62	$156.26	$233.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.47 / $38.44 / $59.07	Professional	26	$23.47	$38.44	$59.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.20 / $117.74 / $180.67	Professional	TC	$72.20	$117.74	$180.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $137.60 / $201.33 / $456.68	Professional		$137.60	$201.33	$456.68
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.95 / $47.93 / $136.96	Professional	26	$33.95	$47.93	$136.96
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $105.28 / $153.16 / $331.39	Professional	TC	$105.28	$153.16	$331.39
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 $146.41 / $150.16 / $162.62	Professional		$146.41	$150.16	$162.62
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.32 / $34.61 / $37.01	Professional	26	$33.32	$34.61	$37.01
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $111.80 / $116.84 / $125.61	Professional	TC	$111.80	$116.84	$125.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $38.72 / $170.12	Professional		$32.34	$38.72	$170.12
United Facility/Professional Professional Modifier Low / Median / High Price $105.89 / $140.97 / $231.25	Professional		$105.89	$140.97	$231.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.81 / $41.42 / $79.26	Professional	26	$28.81	$41.42	$79.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.95 / $110.80 / $181.11	Professional	TC	$76.95	$110.80	$181.11