Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.99 / $57.42 / $65.30	Facility	26	$34.99	$57.42	$65.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.04 / $118.63 / $221.81	Professional		$101.04	$118.63	$221.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $39.33 / $93.13	Professional	26	$29.91	$39.33	$93.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.14 / $82.19 / $143.72	Professional	TC	$71.14	$82.19	$143.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.99 / $121.55 / $121.55	Professional		$62.99	$121.55	$121.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.04 / $32.51 / $63.09	Professional	26	$28.04	$32.51	$63.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.30 / $120.81 / $268.94	Professional		$48.30	$120.81	$268.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.96 / $149.91 / $226.24	Professional		$97.96	$149.91	$226.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.60 / $50.00 / $76.31	Professional	26	$30.60	$50.00	$76.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.87 / $105.45 / $154.69	Professional	TC	$62.87	$105.45	$154.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $133.01 / $193.57 / $695.86	Professional		$133.01	$193.57	$695.86
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.28 / $64.45 / $258.37	Professional	26	$46.28	$64.45	$258.37
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.17 / $130.56 / $491.66	Professional	TC	$87.17	$130.56	$491.66
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 $142.78 / $145.81 / $157.27	Professional		$142.78	$145.81	$157.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.27 / $47.46 / $50.18	Professional	26	$46.27	$47.46	$50.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $95.30 / $99.54 / $107.11	Professional	TC	$95.30	$99.54	$107.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $52.50 / $164.53	Professional		$32.34	$52.50	$164.53
United Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $146.63 / $225.47	Professional		$106.70	$146.63	$225.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.47 / $48.48 / $78.47	Professional	26	$35.47	$48.48	$78.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.56 / $96.95 / $150.97	Professional	TC	$72.56	$96.95	$150.97