Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $77.62 / $151.36	Facility	26	$41.69	$77.62	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $154.88	Professional		$54.95	$67.61	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $53.70 / $173.78	Professional	26	$38.02	$53.70	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $19.95 / $35.48	Professional	TC	$15.14	$19.95	$35.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $33.88 / $57.54	Professional	26	$33.88	$33.88	$57.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $100.00 / $151.36	Professional		$58.88	$100.00	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $87.10 / $123.03	Professional		$57.54	$87.10	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $60.26 / $89.13	Professional	26	$42.66	$60.26	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.70 / $38.02	Professional	TC	$17.78	$25.70	$38.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $346.74	Professional		$72.44	$114.82	$346.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $74.13 / $295.12	Professional	26	$48.98	$74.13	$295.12
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.18 / $151.36	Professional	TC	$19.05	$28.18	$151.36
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 $79.43 / $79.43 / $87.10	Professional		$79.43	$79.43	$87.10
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $57.54 / $60.26	Professional	26	$56.23	$57.54	$60.26
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $22.91 / $25.12	Professional	TC	$22.39	$22.91	$25.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $81.28 / $120.23	Professional		$64.57	$81.28	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $56.23 / $83.18	Professional	26	$44.67	$56.23	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $23.99 / $33.88	Professional	TC	$19.05	$23.99	$33.88