Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.68 / $96.93 / $136.97	Facility	26	$74.68	$96.93	$136.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.58 / $163.03 / $273.33	Professional		$137.58	$163.03	$273.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.54 / $80.15 / $274.33	Professional	26	$52.54	$80.15	$274.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.44 / $97.59 / $138.63	Professional	TC	$68.44	$97.59	$138.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.40 / $102.84 / $123.51	Professional		$76.40	$102.84	$123.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.70 / $69.16 / $94.45	Professional	26	$47.70	$69.16	$94.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $159.19 / $286.86	Professional		$87.56	$159.19	$286.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.65 / $69.65 / $69.65	Facility	26	$69.65	$69.65	$69.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.86 / $190.80 / $370.01	Professional		$122.86	$190.80	$370.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.86 / $89.55 / $130.83	Professional	26	$56.86	$89.55	$130.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.49 / $89.29 / $294.89	Professional	TC	$56.49	$89.29	$294.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $144.06 / $210.87 / $973.96	Professional		$144.06	$210.87	$973.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.81 / $115.94 / $477.78	Professional	26	$82.81	$115.94	$477.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.96 / $85.75 / $498.98	Professional	TC	$62.96	$85.75	$498.98
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 $152.30 / $152.46 / $165.36	Professional		$152.30	$152.46	$165.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.50 / $86.13 / $90.95	Professional	26	$83.50	$86.13	$90.95
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.25 / $66.16 / $74.41	Professional	TC	$63.25	$66.16	$74.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $77.84 / $172.99	Professional		$32.34	$77.84	$172.99
United Facility/Professional Professional Modifier Low / Median / High Price $142.08 / $201.51 / $373.27	Professional		$142.08	$201.51	$373.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.58 / $82.26 / $149.76	Professional	26	$59.58	$82.26	$149.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.93 / $106.48 / $213.79	Professional	TC	$72.93	$106.48	$213.79