Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.31 / $79.34 / $85.46	Facility	26	$48.31	$79.34	$85.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.07 / $149.74 / $233.94	Professional		$130.07	$149.74	$233.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.14 / $48.57 / $87.14	Professional	26	$42.14	$48.57	$87.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.83 / $102.81 / $165.99	Professional	TC	$82.83	$102.81	$165.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.53 / $57.80 / $66.69	Professional	26	$54.53	$57.80	$66.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.87 / $154.71 / $281.74	Professional		$56.87	$154.71	$281.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.51 / $59.51 / $59.51	Facility	26	$59.51	$59.51	$59.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.68 / $202.67 / $310.41	Professional		$129.68	$202.67	$310.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.01 / $62.30 / $94.04	Professional	26	$38.01	$62.30	$94.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.14 / $134.15 / $226.36	Professional	TC	$84.14	$134.15	$226.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.40 / $232.96 / $625.71	Professional		$150.40	$232.96	$625.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.38 / $77.54 / $269.12	Professional	26	$54.38	$77.54	$269.12
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $99.49 / $153.44 / $362.77	Professional	TC	$99.49	$153.44	$362.77
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 $157.44 / $160.36 / $173.06	Professional		$157.44	$160.36	$173.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.38 / $56.00 / $59.07	Professional	26	$54.38	$56.00	$59.07
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $101.44 / $105.98 / $113.98	Professional	TC	$101.44	$105.98	$113.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $61.80 / $181.04	Professional		$32.34	$61.80	$181.04
United Facility/Professional Professional Modifier Low / Median / High Price $145.74 / $199.36 / $298.93	Professional		$145.74	$199.36	$298.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.28 / $58.69 / $101.05	Professional	26	$47.28	$58.69	$101.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.47 / $142.55 / $208.97	Professional	TC	$96.47	$142.55	$208.97