Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.76 / $38.26 / $45.09	Facility	26	$22.76	$38.26	$45.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.81 / $121.35 / $236.63	Professional		$82.81	$121.35	$236.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $28.00 / $74.97	Professional	26	$22.71	$28.00	$74.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.92 / $96.68 / $165.60	Professional	TC	$59.92	$96.68	$165.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $23.88 / $34.44	Professional	26	$18.14	$23.88	$34.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.92 / $114.00 / $255.41	Professional		$31.92	$114.00	$255.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.54 / $149.28 / $229.97	Professional		$86.54	$149.28	$229.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.52 / $34.57 / $53.37	Professional	26	$21.52	$34.57	$53.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.00 / $120.95 / $182.84	Professional	TC	$59.00	$120.95	$182.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $123.87 / $194.86 / $503.12	Professional		$123.87	$194.86	$503.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.61 / $43.36 / $174.30	Professional	26	$30.61	$43.36	$174.30
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.02 / $139.61 / $327.99	Professional	TC	$77.02	$139.61	$327.99
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 $142.72 / $146.80 / $158.33	Professional		$142.72	$146.80	$158.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.36 / $31.32 / $33.15	Professional	26	$30.36	$31.32	$33.15
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $111.41 / $116.44 / $125.16	Professional	TC	$111.41	$116.44	$125.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $34.69 / $165.63	Professional		$32.34	$34.69	$165.63
United Facility/Professional Professional Modifier Low / Median / High Price $91.96 / $141.40 / $240.86	Professional		$91.96	$141.40	$240.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.39 / $32.04 / $50.45	Professional	26	$26.39	$32.04	$50.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.28 / $114.73 / $201.18	Professional	TC	$68.28	$114.73	$201.18