Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.98 / $47.92 / $56.75	Facility	26	$29.98	$47.92	$56.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.23 / $160.90 / $370.00	Professional		$116.23	$160.90	$370.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.50 / $40.03 / $168.21	Professional	26	$28.50	$40.03	$168.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.75 / $99.56 / $206.32	Professional	TC	$86.75	$99.56	$206.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.46 / $149.51 / $193.47	Professional		$115.46	$149.51	$193.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.45 / $40.90 / $59.03	Professional	26	$24.45	$40.90	$59.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $208.32 / $431.79	Professional		$40.11	$208.32	$431.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.67 / $205.62 / $334.53	Professional		$107.67	$205.62	$334.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.22 / $44.87 / $68.31	Professional	26	$28.22	$44.87	$68.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.19 / $177.76 / $277.24	Professional	TC	$72.19	$177.76	$277.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $182.48 / $285.66 / $604.91	Professional		$182.48	$285.66	$604.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.42 / $51.45 / $446.91	Professional	26	$35.42	$51.45	$446.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.56 / $218.61 / $454.65	Professional	TC	$69.56	$218.61	$454.65
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 $229.23 / $237.22 / $254.58	Professional		$229.23	$237.22	$254.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.35 / $39.77 / $41.67	Professional	26	$39.35	$39.77	$41.67
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $189.46 / $197.87 / $212.91	Professional	TC	$189.46	$197.87	$212.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $43.59 / $191.64	Professional		$32.34	$43.59	$191.64
United Facility/Professional Professional Modifier Low / Median / High Price $122.74 / $175.89 / $280.22	Professional		$122.74	$175.89	$280.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.43 / $40.93 / $61.72	Professional	26	$31.43	$40.93	$61.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.01 / $138.15 / $230.21	Professional	TC	$89.01	$138.15	$230.21