Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.59 / $95.82 / $118.07	Facility	26	$66.59	$95.82	$118.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.02 / $190.55 / $258.80	Professional		$110.02	$190.55	$258.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.65 / $65.47 / $110.44	Professional	26	$49.65	$65.47	$110.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.18 / $100.72 / $187.06	Professional	TC	$50.18	$100.72	$187.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.19 / $89.17 / $89.17	Professional		$82.19	$89.17	$89.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.22 / $86.63 / $86.63	Professional	26	$41.22	$86.63	$86.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.35 / $162.32 / $289.83	Professional		$90.35	$162.32	$289.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.67 / $199.81 / $632.00	Professional		$111.67	$199.81	$632.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.33 / $86.91 / $135.00	Professional	26	$52.33	$86.91	$135.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.28 / $98.58 / $539.83	Professional	TC	$54.28	$98.58	$539.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.94 / $236.72 / $765.99	Professional		$147.94	$236.72	$765.99
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.77 / $117.20 / $415.69	Professional	26	$77.77	$117.20	$415.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.79 / $102.48 / $564.15	Professional	TC	$64.79	$102.48	$564.15
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 $148.12 / $153.87 / $169.99	Professional		$148.12	$153.87	$169.99
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.56 / $86.16 / $93.85	Professional	26	$77.56	$86.16	$93.85
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.69 / $70.56 / $76.13	Professional	TC	$67.69	$70.56	$76.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $72.90 / $177.83	Professional		$32.34	$72.90	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $138.78 / $216.84 / $508.15	Professional		$138.78	$216.84	$508.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.00 / $82.59 / $138.41	Professional	26	$59.00	$82.59	$138.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.17 / $112.92 / $326.63	Professional	TC	$66.17	$112.92	$326.63