Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.89 / $48.07 / $84.94	Facility	26	$32.89	$48.07	$84.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.36 / $152.13 / $278.29	Professional		$125.36	$152.13	$278.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.43 / $38.01 / $96.07	Professional	26	$31.43	$38.01	$96.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.47 / $116.68 / $207.79	Professional	TC	$93.47	$116.68	$207.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.61 / $43.56 / $47.43	Professional	26	$26.61	$43.56	$47.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.43 / $143.63 / $323.94	Professional		$45.43	$143.63	$323.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.34 / $197.74 / $287.16	Professional		$124.34	$197.74	$287.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.46 / $49.01 / $73.22	Professional	26	$30.46	$49.01	$73.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.22 / $148.72 / $216.74	Professional	TC	$90.22	$148.72	$216.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $158.74 / $234.35 / $554.42	Professional		$158.74	$234.35	$554.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.77 / $54.45 / $160.88	Professional	26	$37.77	$54.45	$160.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $110.73 / $158.63 / $329.08	Professional	TC	$110.73	$158.63	$329.08
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 $171.96 / $176.06 / $190.41	Professional		$171.96	$176.06	$190.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.11 / $43.38 / $47.19	Professional	26	$40.11	$43.38	$47.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $121.74 / $127.34 / $143.22	Professional	TC	$121.74	$127.34	$143.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $49.37 / $199.20	Professional		$32.34	$49.37	$199.20
United Facility/Professional Professional Modifier Low / Median / High Price $140.19 / $180.82 / $295.91	Professional		$140.19	$180.82	$295.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.77 / $45.41 / $73.22	Professional	26	$34.77	$45.41	$73.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.34 / $134.22 / $222.69	Professional	TC	$106.34	$134.22	$222.69