Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.62 / $46.59 / $55.24	Facility	26	$28.62	$46.59	$55.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.78 / $131.24 / $399.66	Professional		$73.78	$131.24	$399.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.75 / $51.89 / $180.00	Professional	26	$27.75	$51.89	$180.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.92 / $59.20 / $117.28	Professional	TC	$41.92	$59.20	$117.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.34 / $81.03 / $110.78	Professional		$58.34	$81.03	$110.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.56 / $34.18 / $41.94	Professional	26	$22.56	$34.18	$41.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $59.95 / $60.20 / $72.00	Professional	TC	$59.95	$60.20	$72.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.89 / $86.53 / $180.84	Professional		$38.89	$86.53	$180.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.01 / $110.77 / $167.91	Professional		$72.01	$110.77	$167.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.81 / $42.67 / $59.96	Professional	26	$26.81	$42.67	$59.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.80 / $69.20 / $105.24	Professional	TC	$44.80	$69.20	$105.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $129.24 / $335.19	Professional		$89.13	$129.24	$335.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.33 / $49.71 / $171.97	Professional	26	$34.33	$49.71	$171.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.28 / $74.94 / $163.62	Professional	TC	$53.28	$74.94	$163.62
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 $96.01 / $97.51 / $105.34	Professional		$96.01	$97.51	$105.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.40 / $38.29 / $40.39	Professional	26	$37.40	$38.29	$40.39
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $57.72 / $60.10 / $64.95	Professional	TC	$57.72	$60.10	$64.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $42.26 / $119.11	Professional		$32.34	$42.26	$119.11
United Facility/Professional Professional Modifier Low / Median / High Price $81.17 / $103.16 / $157.60	Professional		$81.17	$103.16	$157.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.40 / $39.22 / $61.11	Professional	26	$30.40	$39.22	$61.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.21 / $65.25 / $96.23	Professional	TC	$49.21	$65.25	$96.23