Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.72 / $58.20 / $84.03	Facility	26	$44.72	$58.20	$84.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.45 / $147.76 / $257.64	Professional		$109.45	$147.76	$257.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $46.35 / $95.28	Professional	26	$29.91	$46.35	$95.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.54 / $101.41 / $180.29	Professional	TC	$79.54	$101.41	$180.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.04 / $97.04 / $97.04	Professional		$97.04	$97.04	$97.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.24 / $48.73 / $65.38	Professional	26	$36.24	$48.73	$65.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.98 / $175.08 / $335.63	Professional		$60.98	$175.08	$335.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.71 / $192.82 / $290.83	Professional		$116.71	$192.82	$290.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.06 / $56.04 / $90.72	Professional	26	$35.06	$56.04	$90.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.53 / $137.58 / $218.46	Professional	TC	$77.53	$137.58	$218.46
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $164.47 / $241.02 / $506.99	Professional		$164.47	$241.02	$506.99
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.60 / $77.97 / $239.92	Professional	26	$53.60	$77.97	$239.92
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.10 / $155.91 / $303.29	Professional	TC	$112.10	$155.91	$303.29
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 $178.18 / $182.46 / $195.83	Professional		$178.18	$182.46	$195.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.18 / $60.24 / $63.35	Professional	26	$59.18	$60.24	$63.35
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.94 / $123.28 / $132.47	Professional	TC	$117.94	$123.28	$132.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $66.27 / $204.87	Professional		$32.34	$66.27	$204.87
United Facility/Professional Professional Modifier Low / Median / High Price $138.94 / $180.12 / $287.70	Professional		$138.94	$180.12	$287.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.85 / $55.54 / $97.75	Professional	26	$35.85	$55.54	$97.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.40 / $134.91 / $209.61	Professional	TC	$98.40	$134.91	$209.61