Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.59 / $60.49 / $74.42	Facility	26	$36.59	$60.49	$74.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.43 / $177.86 / $460.93	Professional		$93.43	$177.86	$460.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.88 / $62.30 / $237.34	Professional	26	$35.88	$62.30	$237.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.82 / $69.16 / $137.27	Professional	TC	$56.82	$69.16	$137.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.81 / $108.07 / $147.88	Professional		$77.81	$108.07	$147.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.71 / $47.86 / $53.88	Professional	26	$29.71	$47.86	$53.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.63 / $64.90 / $94.04	Professional	TC	$60.63	$64.90	$94.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $114.95 / $241.82	Professional		$49.95	$114.95	$241.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.42 / $145.88 / $215.03	Professional		$92.42	$145.88	$215.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.56 / $55.88 / $81.80	Professional	26	$35.56	$55.88	$81.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.87 / $92.01 / $136.76	Professional	TC	$49.87	$92.01	$136.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $111.80 / $162.11 / $402.20	Professional		$111.80	$162.11	$402.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.90 / $61.76 / $220.89	Professional	26	$43.90	$61.76	$220.89
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.69 / $97.01 / $226.88	Professional	TC	$66.69	$97.01	$226.88
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 $128.38 / $131.53 / $140.49	Professional		$128.38	$131.53	$140.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.30 / $49.56 / $51.88	Professional	26	$49.30	$49.56	$51.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $78.81 / $82.24 / $88.61	Professional	TC	$78.81	$82.24	$88.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $54.28 / $158.86	Professional		$32.34	$54.28	$158.86
United Facility/Professional Professional Modifier Low / Median / High Price $102.08 / $132.32 / $207.23	Professional		$102.08	$132.32	$207.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.15 / $51.52 / $79.22	Professional	26	$40.15	$51.52	$79.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.08 / $84.06 / $131.87	Professional	TC	$64.08	$84.06	$131.87