Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.34 / $41.25 / $61.68	Facility	26	$29.34	$41.25	$61.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.73 / $137.81 / $210.24	Professional		$83.73	$137.81	$210.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.71 / $41.26 / $75.93	Professional	26	$15.71	$41.26	$75.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.95 / $77.58 / $174.04	Professional	TC	$42.95	$77.58	$174.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.27 / $68.27 / $68.27	Professional		$68.27	$68.27	$68.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.72 / $56.08 / $59.75	Professional	26	$36.72	$56.08	$59.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.48 / $113.38 / $206.47	Professional		$58.48	$113.38	$206.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.88 / $146.24 / $587.99	Professional		$77.88	$146.24	$587.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.67 / $47.06 / $84.12	Professional	26	$19.67	$47.06	$84.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.57 / $84.35 / $539.83	Professional	TC	$46.57	$84.35	$539.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $113.16 / $177.50 / $706.20	Professional		$113.16	$177.50	$706.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.06 / $73.58 / $319.02	Professional	26	$44.06	$73.58	$319.02
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.32 / $85.15 / $451.48	Professional	TC	$55.32	$85.15	$451.48
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 $115.22 / $115.38 / $126.13	Professional		$115.22	$115.38	$126.13
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.72 / $57.28 / $60.75	Professional	26	$54.72	$57.28	$60.75
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.11 / $60.50 / $65.38	Professional	TC	$58.11	$60.50	$65.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $61.68 / $131.94	Professional		$32.34	$61.68	$131.94
United Facility/Professional Professional Modifier Low / Median / High Price $103.46 / $150.80 / $424.22	Professional		$103.46	$150.80	$424.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.70 / $47.31 / $94.97	Professional	26	$18.70	$47.31	$94.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.91 / $95.86 / $315.45	Professional	TC	$56.91	$95.86	$315.45