Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.23 / $40.92 / $58.20	Facility	26	$29.23	$40.92	$58.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.87 / $132.12 / $524.94	Professional		$90.87	$132.12	$524.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.56 / $49.72 / $153.90	Professional	26	$29.56	$49.72	$153.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.62 / $90.56 / $262.08	Professional	TC	$60.62	$90.56	$262.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.37 / $84.87 / $143.57	Professional		$68.37	$84.87	$143.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.92 / $26.44 / $42.97	Professional	26	$23.92	$26.44	$42.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.55 / $65.00 / $86.98	Professional	TC	$51.55	$65.00	$86.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.93 / $121.81 / $233.50	Professional		$40.93	$121.81	$233.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.21 / $141.96 / $218.04	Professional		$92.21	$141.96	$218.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.94 / $45.07 / $65.41	Professional	26	$27.94	$45.07	$65.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.99 / $97.81 / $151.87	Professional	TC	$60.99	$97.81	$151.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $115.68 / $166.86 / $502.74	Professional		$115.68	$166.86	$502.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.14 / $52.34 / $225.52	Professional	26	$36.14	$52.34	$225.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.48 / $108.20 / $227.78	Professional	TC	$72.48	$108.20	$227.78
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 $123.96 / $126.30 / $136.71	Professional		$123.96	$126.30	$136.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.49 / $40.34 / $42.52	Professional	26	$39.49	$40.34	$42.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.62 / $86.80 / $94.19	Professional	TC	$83.62	$86.80	$94.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $44.49 / $154.59	Professional		$32.34	$44.49	$154.59
United Facility/Professional Professional Modifier Low / Median / High Price $105.83 / $134.02 / $198.32	Professional		$105.83	$134.02	$198.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $45.52 / $85.34	Professional	26	$33.22	$45.52	$85.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.13 / $95.76 / $141.65	Professional	TC	$72.13	$95.76	$141.65