Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.60 / $43.51 / $45.69	Facility	26	$25.60	$43.51	$45.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.65 / $102.71 / $186.26	Professional		$84.65	$102.71	$186.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.17 / $26.82 / $63.00	Professional	26	$23.17	$26.82	$63.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.01 / $74.73 / $125.75	Professional	TC	$61.01	$74.73	$125.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.02 / $93.92 / $127.62	Professional		$59.02	$93.92	$127.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.38 / $31.79 / $33.65	Professional	26	$19.38	$31.79	$33.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.15 / $98.93 / $220.24	Professional		$33.15	$98.93	$220.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.62 / $128.43 / $190.65	Professional		$80.62	$128.43	$190.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.38 / $35.76 / $54.98	Professional	26	$22.38	$35.76	$54.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.11 / $93.58 / $143.97	Professional	TC	$59.11	$93.58	$143.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $111.58 / $169.32 / $410.24	Professional		$111.58	$169.32	$410.24
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.29 / $45.68 / $146.57	Professional	26	$30.29	$45.68	$146.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.29 / $118.01 / $262.57	Professional	TC	$81.29	$118.01	$262.57
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 $116.92 / $119.20 / $129.47	Professional		$116.92	$119.20	$129.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.59 / $32.54 / $34.44	Professional	26	$31.59	$32.54	$34.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.38 / $87.61 / $95.04	Professional	TC	$84.38	$87.61	$95.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $36.03 / $135.46	Professional		$32.34	$36.03	$135.46
United Facility/Professional Professional Modifier Low / Median / High Price $91.88 / $119.44 / $188.29	Professional		$91.88	$119.44	$188.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.08 / $35.40 / $55.47	Professional	26	$27.08	$35.40	$55.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.80 / $88.28 / $127.48	Professional	TC	$64.80	$88.28	$127.48