Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $38.90 / $87.10	Facility	26	$25.70	$38.90	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $269.15	Professional		$77.62	$104.71	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $41.69 / $100.00	Professional	26	$22.91	$41.69	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $72.44 / $134.90	Professional	TC	$54.95	$72.44	$134.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $23.99 / $38.90	Professional	26	$21.38	$23.99	$38.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $95.50 / $213.80	Professional		$36.31	$95.50	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $177.83	Professional		$75.86	$114.82	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $34.67 / $54.95	Professional	26	$21.88	$34.67	$54.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $85.11 / $125.89	Professional	TC	$52.48	$85.11	$125.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $194.98 / $363.08	Professional		$100.00	$194.98	$363.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $54.95 / $194.98	Professional	26	$31.62	$54.95	$194.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $102.33 / $218.78	Professional	TC	$63.10	$102.33	$218.78
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 $112.20 / $114.82 / $125.89	Professional		$112.20	$114.82	$125.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $35.48 / $37.15	Professional	26	$34.67	$35.48	$37.15
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $81.28 / $87.10	Professional	TC	$77.62	$81.28	$87.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $169.82	Professional		$81.28	$107.15	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $32.36 / $54.95	Professional	26	$23.44	$32.36	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $75.86 / $117.49	Professional	TC	$57.54	$75.86	$117.49