Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.86 / $53.61 / $64.19	Facility	26	$32.86	$53.61	$64.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.07 / $137.72 / $485.00	Professional		$84.07	$137.72	$485.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.13 / $56.25 / $197.89	Professional	26	$32.13	$56.25	$197.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.42 / $64.31 / $135.38	Professional	TC	$47.42	$64.31	$135.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.56 / $95.68 / $125.40	Professional		$63.56	$95.68	$125.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.46 / $40.63 / $48.13	Professional	26	$26.46	$40.63	$48.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $53.48 / $77.56 / $77.56	Professional	TC	$53.48	$77.56	$77.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.62 / $99.50 / $205.37	Professional		$44.62	$99.50	$205.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.94 / $125.80 / $189.37	Professional		$81.94	$125.80	$189.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.25 / $49.83 / $71.48	Professional	26	$31.25	$49.83	$71.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.70 / $78.14 / $119.43	Professional	TC	$50.70	$78.14	$119.43
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $101.09 / $147.04 / $513.66	Professional		$101.09	$147.04	$513.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.22 / $57.04 / $198.28	Professional	26	$39.22	$57.04	$198.28
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.86 / $89.98 / $279.20	Professional	TC	$61.86	$89.98	$279.20
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 $109.03 / $110.97 / $119.47	Professional		$109.03	$110.97	$119.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.23 / $44.02 / $46.35	Professional	26	$43.23	$44.02	$46.35
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $65.01 / $67.73 / $73.11	Professional	TC	$65.01	$67.73	$73.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $48.48 / $135.09	Professional		$32.34	$48.48	$135.09
United Facility/Professional Professional Modifier Low / Median / High Price $91.71 / $116.92 / $178.94	Professional		$91.71	$116.92	$178.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $51.82 / $95.11	Professional	26	$36.61	$51.82	$95.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.19 / $81.16 / $123.00	Professional	TC	$59.19	$81.16	$123.00