Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.82 / $45.68 / $54.61	Facility	26	$29.82	$45.68	$54.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.51 / $105.84 / $214.55	Professional		$66.51	$105.84	$214.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.03 / $29.83 / $55.75	Professional	26	$24.03	$29.83	$55.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.50 / $74.87 / $133.80	Professional	TC	$42.50	$74.87	$133.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.81 / $82.26 / $96.78	Professional		$60.81	$82.26	$96.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.02 / $20.87 / $35.00	Professional	26	$20.02	$20.87	$35.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $118.39 / $226.95	Professional		$34.79	$118.39	$226.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.21 / $33.21 / $33.21	Facility	26	$33.21	$33.21	$33.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.93 / $137.60 / $205.67	Professional		$86.93	$137.60	$205.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.14 / $37.20 / $56.90	Professional	26	$23.14	$37.20	$56.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.98 / $99.58 / $144.30	Professional	TC	$61.98	$99.58	$144.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.83 / $164.11 / $368.64	Professional		$112.83	$164.11	$368.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.58 / $42.66 / $143.83	Professional	26	$30.58	$42.66	$143.83
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.28 / $112.85 / $276.29	Professional	TC	$79.28	$112.85	$276.29
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 $120.48 / $122.88 / $133.34	Professional		$120.48	$122.88	$133.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.25 / $34.19 / $36.14	Professional	26	$33.25	$34.19	$36.14
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $86.29 / $89.62 / $97.20	Professional	TC	$86.29	$89.62	$97.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $37.81 / $139.50	Professional		$32.34	$37.81	$139.50
United Facility/Professional Professional Modifier Low / Median / High Price $93.74 / $125.50 / $216.74	Professional		$93.74	$125.50	$216.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.31 / $35.01 / $55.61	Professional	26	$27.31	$35.01	$55.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.13 / $93.10 / $156.24	Professional	TC	$66.13	$93.10	$156.24