Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.84 / $76.20 / $109.58	Facility	26	$42.84	$76.20	$109.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $60.87 / $114.12	Professional		$55.57	$60.87	$114.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $42.84 / $91.31	Professional	26	$37.99	$42.84	$91.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.79 / $19.94 / $31.45	Professional	TC	$15.79	$19.94	$31.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.90 / $68.90 / $68.90	Professional		$68.90	$68.90	$68.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.00 / $56.00 / $56.00	Professional	26	$56.00	$56.00	$56.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.61 / $99.83 / $150.22	Professional		$58.61	$99.83	$150.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.38 / $89.57 / $135.35	Professional		$59.38	$89.57	$135.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.17 / $63.22 / $98.60	Professional	26	$42.17	$63.22	$98.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $26.34 / $38.33	Professional	TC	$18.39	$26.34	$38.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.98 / $106.16 / $317.87	Professional		$72.98	$106.16	$317.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.51 / $74.93 / $272.60	Professional	26	$51.51	$74.93	$272.60
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.98 / $29.19 / $133.32	Professional	TC	$18.98	$29.19	$133.32
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 $79.53 / $79.76 / $86.26	Professional		$79.53	$79.76	$86.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.46 / $57.32 / $60.88	Professional	26	$56.46	$57.32	$60.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.44 / $23.08 / $25.36	Professional	TC	$22.44	$23.08	$25.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.16 / $32.34 / $90.24	Professional		$24.16	$32.34	$90.24
United Facility/Professional Professional Modifier Low / Median / High Price $63.51 / $80.64 / $132.77	Professional		$63.51	$80.64	$132.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.34 / $56.78 / $92.50	Professional	26	$44.34	$56.78	$92.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $25.22 / $38.67	Professional	TC	$19.12	$25.22	$38.67