Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $69.18 / $120.23	Facility	26	$36.31	$69.18	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $186.21 / $512.86	Professional		$97.72	$186.21	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $72.44 / $223.87	Professional	26	$37.15	$72.44	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $85.11 / $194.98	Professional	TC	$56.23	$85.11	$194.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $89.13 / $147.91	Professional		$74.13	$89.13	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $39.81 / $56.23	Professional	26	$30.20	$39.81	$56.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $61.66 / $91.20	Professional	TC	$47.86	$61.66	$91.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $112.20 / $239.88	Professional		$50.12	$112.20	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $138.04 / $218.78	Professional		$91.20	$138.04	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $56.23 / $85.11	Professional	26	$35.48	$56.23	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $91.20 / $144.54	Professional	TC	$53.70	$91.20	$144.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $190.55 / $524.81	Professional		$112.20	$190.55	$524.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $70.79 / $275.42	Professional	26	$43.65	$70.79	$275.42
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $97.72 / $251.19	Professional	TC	$60.26	$97.72	$251.19
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 $128.82 / $131.83 / $141.25	Professional		$128.82	$131.83	$141.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $50.12 / $51.29	Professional	26	$48.98	$50.12	$51.29
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $83.18 / $89.13	Professional	TC	$79.43	$83.18	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $199.53	Professional		$100.00	$128.82	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $48.98 / $75.86	Professional	26	$38.90	$48.98	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $79.43 / $123.03	Professional	TC	$60.26	$79.43	$123.03