Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.89 / $62.60 / $84.32	Facility	26	$42.89	$62.60	$84.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.79 / $187.57 / $580.32	Professional		$103.79	$187.57	$580.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.05 / $70.54 / $241.61	Professional	26	$42.05	$70.54	$241.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.97 / $79.34 / $159.00	Professional	TC	$58.97	$79.34	$159.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.40 / $105.87 / $159.06	Professional		$82.40	$105.87	$159.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.95 / $49.46 / $63.59	Professional	26	$34.95	$49.46	$63.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $59.33 / $69.65 / $83.96	Professional	TC	$59.33	$69.65	$83.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.95 / $136.09 / $260.87	Professional		$58.95	$136.09	$260.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.93 / $159.80 / $237.41	Professional		$102.93	$159.80	$237.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.31 / $65.47 / $93.72	Professional	26	$41.31	$65.47	$93.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.81 / $93.80 / $147.63	Professional	TC	$50.81	$93.80	$147.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $127.84 / $186.53 / $465.54	Professional		$127.84	$186.53	$465.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.81 / $75.36 / $254.39	Professional	26	$51.81	$75.36	$254.39
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.17 / $107.01 / $275.02	Professional	TC	$74.17	$107.01	$275.02
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 $138.49 / $140.91 / $151.55	Professional		$138.49	$140.91	$151.55
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.07 / $58.14 / $61.23	Professional	26	$57.07	$58.14	$61.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $80.34 / $83.84 / $90.32	Professional	TC	$80.34	$83.84	$90.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $64.06 / $159.60	Professional		$32.34	$64.06	$159.60
United Facility/Professional Professional Modifier Low / Median / High Price $117.66 / $150.03 / $224.12	Professional		$117.66	$150.03	$224.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.15 / $60.98 / $90.22	Professional	26	$46.15	$60.98	$90.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.41 / $93.39 / $134.41	Professional	TC	$69.41	$93.39	$134.41