Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.53 / $41.34 / $56.60	Facility	26	$29.53	$41.34	$56.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.83 / $107.06 / $202.79	Professional		$94.83	$107.06	$202.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.18 / $33.25 / $65.63	Professional	26	$29.18	$33.25	$65.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.30 / $74.94 / $128.62	Professional	TC	$65.30	$74.94	$128.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.58 / $97.69 / $139.47	Professional		$80.58	$97.69	$139.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.99 / $32.90 / $44.94	Professional	26	$24.99	$32.90	$44.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.15 / $125.61 / $240.79	Professional		$42.15	$125.61	$240.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.74 / $143.94 / $214.39	Professional		$87.74	$143.94	$214.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.08 / $45.47 / $70.44	Professional	26	$28.08	$45.47	$70.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.10 / $99.69 / $146.22	Professional	TC	$61.10	$99.69	$146.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $122.11 / $186.83 / $589.54	Professional		$122.11	$186.83	$589.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.04 / $50.88 / $187.02	Professional	26	$37.04	$50.88	$187.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $82.26 / $112.17 / $322.14	Professional	TC	$82.26	$112.17	$322.14
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 $127.83 / $130.34 / $141.00	Professional		$127.83	$130.34	$141.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.22 / $40.04 / $43.78	Professional	26	$37.22	$40.04	$43.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $82.63 / $86.49 / $97.21	Professional	TC	$82.63	$86.49	$97.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $45.80 / $147.51	Professional		$32.34	$45.80	$147.51
United Facility/Professional Professional Modifier Low / Median / High Price $103.68 / $144.03 / $235.81	Professional		$103.68	$144.03	$235.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $44.75 / $68.28	Professional	26	$34.15	$44.75	$68.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.68 / $92.28 / $144.26	Professional	TC	$70.68	$92.28	$144.26