Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.33 / $72.26 / $83.22	Facility	26	$46.33	$72.26	$83.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.09 / $105.29 / $175.80	Professional		$80.09	$105.29	$175.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.96 / $48.29 / $119.87	Professional	26	$40.96	$48.29	$119.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.14 / $54.64 / $84.67	Professional	TC	$36.14	$54.64	$84.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.76 / $50.76 / $50.76	Professional	26	$50.76	$50.76	$50.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.53 / $117.19 / $215.08	Professional		$63.53	$117.19	$215.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.27 / $143.63 / $274.89	Professional		$91.27	$143.63	$274.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.87 / $68.53 / $107.46	Professional	26	$45.87	$68.53	$107.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.17 / $67.48 / $172.72	Professional	TC	$43.17	$67.48	$172.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $105.34 / $162.49 / $781.75	Professional		$105.34	$162.49	$781.75
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.84 / $81.09 / $510.45	Professional	26	$55.84	$81.09	$510.45
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.49 / $76.48 / $469.99	Professional	TC	$49.49	$76.48	$469.99
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 $114.18 / $115.49 / $124.49	Professional		$114.18	$115.49	$124.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.43 / $62.22 / $65.98	Professional	26	$61.43	$62.22	$65.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.97 / $54.07 / $58.49	Professional	TC	$51.97	$54.07	$58.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $61.19 / $130.22	Professional		$32.34	$61.19	$130.22
United Facility/Professional Professional Modifier Low / Median / High Price $96.72 / $132.12 / $239.41	Professional		$96.72	$132.12	$239.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.19 / $61.99 / $102.64	Professional	26	$48.19	$61.99	$102.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.39 / $65.37 / $134.06	Professional	TC	$44.39	$65.37	$134.06