Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.09 / $39.28 / $47.03	Facility	26	$24.09	$39.28	$47.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.06 / $102.12 / $256.76	Professional		$86.06	$102.12	$256.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $28.36 / $70.25	Professional	26	$23.34	$28.36	$70.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.40 / $73.73 / $149.83	Professional	TC	$61.40	$73.73	$149.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.33 / $83.63 / $117.58	Professional		$60.33	$83.63	$117.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $19.98 / $34.52	Professional	26	$18.62	$19.98	$34.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.74 / $123.36 / $236.49	Professional		$32.74	$123.36	$236.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.94 / $138.96 / $192.41	Professional		$86.94	$138.96	$192.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.64 / $35.89 / $52.18	Professional	26	$22.64	$35.89	$52.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.92 / $103.86 / $143.69	Professional	TC	$64.92	$103.86	$143.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $117.58 / $171.02 / $481.47	Professional		$117.58	$171.02	$481.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.78 / $41.86 / $156.87	Professional	26	$28.78	$41.86	$156.87
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.37 / $114.94 / $241.14	Professional	TC	$81.37	$114.94	$241.14
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 $125.54 / $128.71 / $138.96	Professional		$125.54	$128.71	$138.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.19 / $32.15 / $34.01	Professional	26	$31.19	$32.15	$34.01
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.21 / $93.39 / $104.95	Professional	TC	$89.21	$93.39	$104.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $35.58 / $145.37	Professional		$32.34	$35.58	$145.37
United Facility/Professional Professional Modifier Low / Median / High Price $101.49 / $128.97 / $201.82	Professional		$101.49	$128.97	$201.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.09 / $33.78 / $52.65	Professional	26	$26.09	$33.78	$52.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.40 / $100.50 / $160.88	Professional	TC	$75.40	$100.50	$160.88