Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.02 / $38.92 / $54.09	Facility	26	$28.02	$38.92	$54.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.53 / $135.29 / $578.20	Professional		$86.53	$135.29	$578.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.48 / $49.29 / $160.55	Professional	26	$27.48	$49.29	$160.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.53 / $84.53 / $165.87	Professional	TC	$56.53	$84.53	$165.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.11 / $76.81 / $110.24	Professional		$65.11	$76.81	$110.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.23 / $28.03 / $41.07	Professional	26	$22.23	$28.03	$41.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $83.76 / $83.77 / $90.00	Professional	TC	$83.76	$83.77	$90.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.06 / $106.61 / $222.31	Professional		$38.06	$106.61	$222.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.62 / $135.29 / $199.31	Professional		$82.62	$135.29	$199.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.07 / $42.00 / $61.24	Professional	26	$26.07	$42.00	$61.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.30 / $90.74 / $141.72	Professional	TC	$54.30	$90.74	$141.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $110.24 / $157.60 / $430.41	Professional		$110.24	$157.60	$430.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.61 / $48.67 / $167.46	Professional	26	$33.61	$48.67	$167.46
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $71.04 / $104.70 / $252.32	Professional	TC	$71.04	$104.70	$252.32
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 $118.03 / $120.16 / $130.29	Professional		$118.03	$120.16	$130.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.58 / $37.47 / $39.54	Professional	26	$36.58	$37.47	$39.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $80.55 / $83.58 / $90.74	Professional	TC	$80.55	$83.58	$90.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $41.37 / $136.30	Professional		$32.34	$41.37	$136.30
United Facility/Professional Professional Modifier Low / Median / High Price $93.85 / $128.19 / $190.44	Professional		$93.85	$128.19	$190.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.94 / $38.40 / $60.00	Professional	26	$28.94	$38.40	$60.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.97 / $90.41 / $138.91	Professional	TC	$57.97	$90.41	$138.91