Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $48.98 / $85.11	Facility	26	$28.84	$48.98	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $123.03 / $501.19	Professional		$69.18	$123.03	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $42.66 / $93.33	Professional	26	$25.12	$42.66	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $85.11 / $218.78	Professional	TC	$43.65	$85.11	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.20 / $53.70	Professional	26	$20.89	$30.20	$53.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $100.00 / $229.09	Professional		$34.67	$100.00	$229.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $33.11 / $33.11	Facility	26	$33.11	$33.11	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $138.04 / $213.80	Professional		$87.10	$138.04	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.02 / $60.26	Professional	26	$22.91	$38.02	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $100.00 / $154.88	Professional	TC	$61.66	$100.00	$154.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $186.21 / $389.05	Professional		$102.33	$186.21	$389.05
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $46.77 / $190.55	Professional	26	$29.51	$46.77	$190.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $117.49 / $309.03	Professional	TC	$74.13	$117.49	$309.03
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 $120.23 / $123.03 / $131.83	Professional		$120.23	$123.03	$131.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $33.88 / $36.31	Professional	26	$33.11	$33.88	$36.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $89.13 / $97.72	Professional	TC	$87.10	$89.13	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $186.21	Professional		$89.13	$120.23	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.88 / $52.48	Professional	26	$25.12	$33.88	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $87.10 / $134.90	Professional	TC	$64.57	$87.10	$134.90