Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.78 / $74.45 / $137.55	Facility	26	$51.78	$74.45	$137.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $192.85 / $276.06	Professional		$163.19	$192.85	$276.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.29 / $74.45 / $82.39	Professional	26	$61.29	$74.45	$82.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.46 / $118.40 / $214.77	Professional	TC	$98.46	$118.40	$214.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.97 / $119.63 / $124.74	Professional		$91.97	$119.63	$124.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.86 / $45.63 / $55.02	Professional	26	$32.86	$45.63	$55.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.38 / $138.97 / $266.39	Professional		$57.38	$138.97	$266.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $121.05 / $191.41 / $638.49	Professional		$121.05	$191.41	$638.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.14 / $75.51 / $307.58	Professional	26	$48.14	$75.51	$307.58
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $73.78 / $116.48 / $487.47	Professional	TC	$73.78	$116.48	$487.47
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 $141.43 / $144.29 / $155.52	Professional		$141.43	$144.29	$155.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.21 / $56.10 / $59.61	Professional	26	$55.21	$56.10	$59.61
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.33 / $89.08 / $95.91	Professional	TC	$85.33	$89.08	$95.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $65.64 / $162.69	Professional		$32.34	$65.64	$162.69
United Facility/Professional Professional Modifier Low / Median / High Price $124.51 / $172.20 / $277.52	Professional		$124.51	$172.20	$277.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.77 / $53.12 / $93.55	Professional	26	$42.77	$53.12	$93.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.31 / $117.48 / $188.39	Professional	TC	$78.31	$117.48	$188.39