Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.17 / $48.25 / $109.89	Facility	26	$32.17	$48.25	$109.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.46 / $147.29 / $435.23	Professional		$111.46	$147.29	$435.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.49 / $44.29 / $146.57	Professional	26	$32.49	$44.29	$146.57
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $34.96 / $119.58 / $341.25	Professional	52	$34.96	$119.58	$341.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.16 / $98.52 / $176.40	Professional	TC	$77.16	$98.52	$176.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $106.20 / $165.56	Professional		$90.73	$106.20	$165.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.37 / $33.56 / $49.45	Professional	26	$26.37	$33.56	$49.45
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $22.65 / $31.10 / $32.49	Professional	52	$22.65	$31.10	$32.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $78.59 / $107.21 / $126.98	Professional	TC	$78.59	$107.21	$126.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.84 / $119.48 / $285.27	Professional		$45.84	$119.48	$285.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.45 / $173.63 / $263.25	Professional		$107.45	$173.63	$263.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.10 / $49.45 / $76.81	Professional	26	$30.10	$49.45	$76.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.47 / $125.01 / $197.12	Professional	TC	$79.47	$125.01	$197.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $145.04 / $214.78 / $510.61	Professional		$145.04	$214.78	$510.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.29 / $62.33 / $209.58	Professional	26	$43.29	$62.33	$209.58
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $101.18 / $145.41 / $309.69	Professional	TC	$101.18	$145.41	$309.69
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 $151.44 / $154.99 / $167.19	Professional		$151.44	$154.99	$167.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.78 / $45.02 / $47.62	Professional	26	$43.78	$45.02	$47.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $106.43 / $111.20 / $119.57	Professional	TC	$106.43	$111.20	$119.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $49.82 / $174.91	Professional		$32.34	$49.82	$174.91
United Facility/Professional Professional Modifier Low / Median / High Price $135.04 / $172.51 / $256.57	Professional		$135.04	$172.51	$256.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.84 / $49.22 / $71.16	Professional	26	$38.84	$49.22	$71.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.48 / $125.02 / $178.19	Professional	TC	$95.48	$125.02	$178.19