Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.49 / $58.20 / $72.39	Facility	26	$37.49	$58.20	$72.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.14 / $134.31 / $261.89	Professional		$109.14	$134.31	$261.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $41.56 / $88.29	Professional	26	$29.91	$41.56	$88.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.23 / $94.16 / $163.71	Professional	TC	$79.23	$94.16	$163.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.57 / $129.52 / $138.37	Professional		$101.57	$129.52	$138.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.43 / $42.52 / $56.20	Professional	26	$31.43	$42.52	$56.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.21 / $158.37 / $303.58	Professional		$53.21	$158.37	$303.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.08 / $170.60 / $255.22	Professional		$108.08	$170.60	$255.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.55 / $53.16 / $80.68	Professional	26	$31.55	$53.16	$80.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.48 / $122.16 / $182.90	Professional	TC	$73.48	$122.16	$182.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.13 / $218.37 / $513.69	Professional		$150.13	$218.37	$513.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.91 / $70.59 / $232.73	Professional	26	$46.91	$70.59	$232.73
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.35 / $146.37 / $297.22	Professional	TC	$96.35	$146.37	$297.22
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 $161.16 / $164.91 / $177.42	Professional		$161.16	$164.91	$177.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $52.44 / $55.28	Professional	26	$51.29	$52.44	$55.28
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $108.73 / $113.62 / $122.16	Professional	TC	$108.73	$113.62	$122.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $57.83 / $185.61	Professional		$32.34	$57.83	$185.61
United Facility/Professional Professional Modifier Low / Median / High Price $121.91 / $158.71 / $253.35	Professional		$121.91	$158.71	$253.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.47 / $48.57 / $85.48	Professional	26	$35.47	$48.57	$85.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.17 / $116.24 / $182.43	Professional	TC	$85.17	$116.24	$182.43