Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $40.74 / $89.13	Facility	26	$29.51	$40.74	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $158.49 / $512.86	Professional		$89.13	$158.49	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $52.48 / $138.04	Professional	26	$29.51	$52.48	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $91.20 / $186.21	Professional	TC	$60.26	$91.20	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $114.82	Professional		$66.07	$81.28	$114.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.90 / $52.48	Professional	26	$23.99	$30.90	$52.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $51.29 / $95.50	Professional	TC	$39.81	$51.29	$95.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $112.20 / $234.42	Professional		$40.74	$112.20	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $223.87	Professional		$91.20	$141.25	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $44.67 / $66.07	Professional	26	$27.54	$44.67	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $97.72 / $158.49	Professional	TC	$61.66	$97.72	$158.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $190.55 / $512.86	Professional		$114.82	$190.55	$512.86
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $58.88 / $309.03	Professional	26	$37.15	$58.88	$309.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $114.82 / $295.12	Professional	TC	$72.44	$114.82	$295.12
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 $123.03 / $125.89 / $138.04	Professional		$123.03	$125.89	$138.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $40.74 / $42.66	Professional	26	$39.81	$40.74	$42.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $87.10 / $93.33	Professional	TC	$83.18	$87.10	$93.33
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 / $190.55	Professional		$100.00	$128.82	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $38.90 / $61.66	Professional	26	$30.90	$38.90	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $91.20 / $131.83	Professional	TC	$67.61	$91.20	$131.83