Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.63 / $46.43 / $92.70	Facility	26	$30.63	$46.43	$92.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.29 / $95.86 / $627.40	Professional		$58.29	$95.86	$627.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.73 / $87.60 / $671.67	Professional	26	$28.73	$87.60	$671.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.34 / $40.02 / $82.69	Professional	TC	$27.34	$40.02	$82.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.06 / $67.81 / $70.45	Professional		$52.06	$67.81	$70.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.05 / $33.22 / $40.08	Professional	26	$24.05	$33.22	$40.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.80 / $79.15 / $151.72	Professional		$41.80	$79.15	$151.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.61 / $94.93 / $138.38	Professional		$65.61	$94.93	$138.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.86 / $45.10 / $69.95	Professional	26	$29.86	$45.10	$69.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.36 / $51.50 / $72.72	Professional	TC	$33.36	$51.50	$72.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $74.59 / $111.53 / $345.40	Professional		$74.59	$111.53	$345.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.74 / $53.44 / $251.19	Professional	26	$36.74	$53.44	$251.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.84 / $56.39 / $219.81	Professional	TC	$37.84	$56.39	$219.81
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 $80.55 / $81.34 / $88.15	Professional		$80.55	$81.34	$88.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.17 / $40.85 / $43.42	Professional	26	$40.17	$40.85	$43.42
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.70 / $41.18 / $44.73	Professional	TC	$39.70	$41.18	$44.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $42.76 / $92.22	Professional		$32.34	$42.76	$92.22
United Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $90.14 / $159.51	Professional		$67.84	$90.14	$159.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $41.66 / $66.72	Professional	26	$31.76	$41.66	$66.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.04 / $48.09 / $69.95	Professional	TC	$35.04	$48.09	$69.95