Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.46 / $41.34 / $56.60	Facility	26	$30.46	$41.34	$56.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $80.50 / $141.40	Professional		$71.34	$80.50	$141.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.18 / $33.19 / $63.99	Professional	26	$29.18	$33.19	$63.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.92 / $48.17 / $83.76	Professional	TC	$41.92	$48.17	$83.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.31 / $77.31 / $77.31	Professional		$77.31	$77.31	$77.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.19 / $29.21 / $47.30	Professional	26	$25.19	$29.21	$47.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.15 / $95.46 / $183.00	Professional		$42.15	$95.46	$183.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.15 / $108.31 / $161.63	Professional		$66.15	$108.31	$161.63
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 $39.22 / $64.20 / $93.80	Professional	TC	$39.22	$64.20	$93.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.28 / $142.36 / $456.96	Professional		$95.28	$142.36	$456.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.04 / $50.88 / $171.98	Professional	26	$37.04	$50.88	$171.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.13 / $71.69 / $203.31	Professional	TC	$53.13	$71.69	$203.31
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 $97.15 / $98.14 / $106.59	Professional		$97.15	$98.14	$106.59
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 $53.37 / $55.81 / $62.79	Professional	TC	$53.37	$55.81	$62.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.33 / $42.93 / $74.73	Professional		$22.33	$42.93	$74.73
United Facility/Professional Professional Modifier Low / Median / High Price $79.50 / $100.48 / $154.72	Professional		$79.50	$100.48	$154.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $44.46 / $66.79	Professional	26	$34.65	$44.46	$66.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.38 / $57.04 / $87.94	Professional	TC	$45.38	$57.04	$87.94