Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.02 / $54.44 / $66.67	Facility	26	$34.02	$54.44	$66.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.25 / $107.41 / $446.00	Professional		$73.25	$107.41	$446.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.11 / $47.17 / $180.70	Professional	26	$32.11	$47.17	$180.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.72 / $53.41 / $97.40	Professional	TC	$39.72	$53.41	$97.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.42 / $103.12 / $117.13	Professional		$62.42	$103.12	$117.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.74 / $39.51 / $45.01	Professional	26	$26.74	$39.51	$45.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $49.45 / $49.45 / $49.45	Professional	TC	$49.45	$49.45	$49.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.03 / $96.75 / $192.51	Professional		$45.03	$96.75	$192.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.45 / $117.92 / $171.63	Professional		$75.45	$117.92	$171.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.29 / $50.38 / $73.93	Professional	26	$32.29	$50.38	$73.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.76 / $69.95 / $101.60	Professional	TC	$41.76	$69.95	$101.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $94.52 / $137.49 / $511.64	Professional		$94.52	$137.49	$511.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.76 / $57.57 / $255.39	Professional	26	$39.76	$57.57	$255.39
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $78.48 / $363.70	Professional	TC	$54.95	$78.48	$363.70
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 $102.19 / $103.77 / $111.71	Professional		$102.19	$103.77	$111.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.33 / $44.67 / $46.77	Professional	26	$44.33	$44.67	$46.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $59.44 / $64.94	Professional	TC	$57.54	$59.44	$64.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $48.93 / $126.32	Professional		$32.34	$48.93	$126.32
United Facility/Professional Professional Modifier Low / Median / High Price $83.91 / $107.09 / $157.41	Professional		$83.91	$107.09	$157.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.38 / $47.12 / $73.38	Professional	26	$36.38	$47.12	$73.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.63 / $61.84 / $91.88	Professional	TC	$46.63	$61.84	$91.88