Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.69 / $39.22 / $47.28	Facility	26	$25.69	$39.22	$47.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $95.15 / $185.54	Professional		$81.68	$95.15	$185.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $29.04 / $61.97	Professional	26	$19.89	$29.04	$61.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.70 / $69.95 / $117.35	Professional	TC	$58.70	$69.95	$117.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.23 / $91.16 / $123.92	Professional		$57.23	$91.16	$123.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.53 / $23.90 / $42.23	Professional	26	$20.53	$23.90	$42.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.02 / $96.00 / $213.72	Professional		$36.02	$96.00	$213.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.84 / $120.35 / $180.04	Professional		$75.84	$120.35	$180.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $35.97 / $54.48	Professional	26	$21.37	$35.97	$54.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.25 / $86.39 / $129.31	Professional	TC	$52.25	$86.39	$129.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $105.91 / $154.05 / $322.25	Professional		$105.91	$154.05	$322.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.66 / $47.67 / $154.47	Professional	26	$31.66	$47.67	$154.47
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.34 / $101.25 / $201.62	Professional	TC	$67.34	$101.25	$201.62
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 $113.45 / $115.93 / $125.16	Professional		$113.45	$115.93	$125.16
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.50 / $35.40 / $37.40	Professional	26	$34.50	$35.40	$37.40
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $78.05 / $81.43 / $87.75	Professional	TC	$78.05	$81.43	$87.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $39.14 / $130.94	Professional		$32.34	$39.14	$130.94
United Facility/Professional Professional Modifier Low / Median / High Price $84.93 / $113.13 / $181.42	Professional		$84.93	$113.13	$181.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.95 / $34.40 / $60.69	Professional	26	$23.95	$34.40	$60.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.15 / $79.05 / $123.31	Professional	TC	$61.15	$79.05	$123.31