Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.79 / $64.54 / $73.73	Facility	26	$39.79	$64.54	$73.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.26 / $92.40 / $256.87	Professional		$77.26	$92.40	$256.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.07 / $40.09 / $114.56	Professional	26	$34.07	$40.09	$114.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $49.65 / $97.38	Professional	TC	$37.11	$49.65	$97.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.89 / $61.98 / $77.76	Professional		$51.89	$61.98	$77.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.06 / $39.84 / $53.43	Professional	26	$27.06	$39.84	$53.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.48 / $93.72 / $170.69	Professional		$47.48	$93.72	$170.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.65 / $116.77 / $214.31	Professional		$63.65	$116.77	$214.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.78 / $52.06 / $79.70	Professional	26	$31.78	$52.06	$79.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.00 / $59.96 / $158.27	Professional	TC	$32.00	$59.96	$158.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $92.32 / $139.77 / $513.69	Professional		$92.32	$139.77	$513.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.63 / $66.42 / $274.50	Professional	26	$43.63	$66.42	$274.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.32 / $63.51 / $231.65	Professional	TC	$46.32	$63.51	$231.65
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 $95.38 / $95.63 / $104.36	Professional		$95.38	$95.63	$104.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.45 / $46.67 / $49.32	Professional	26	$45.45	$46.67	$49.32
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.79 / $48.71 / $55.04	Professional	TC	$46.79	$48.71	$55.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $50.26 / $109.18	Professional		$32.34	$50.26	$109.18
United Facility/Professional Professional Modifier Low / Median / High Price $72.98 / $107.09 / $190.41	Professional		$72.98	$107.09	$190.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.27 / $51.68 / $83.92	Professional	26	$39.27	$51.68	$83.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.42 / $48.72 / $100.00	Professional	TC	$31.42	$48.72	$100.00