Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.32 / $65.50 / $65.72	Facility	26	$37.32	$65.50	$65.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.52 / $115.87 / $196.47	Professional		$52.52	$115.87	$196.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.89 / $38.71 / $72.77	Professional	26	$34.89	$38.71	$72.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.03 / $80.98 / $140.28	Professional	TC	$16.03	$80.98	$140.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $143.08 / $143.08 / $143.08	Professional		$143.08	$143.08	$143.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.42 / $158.38 / $303.62	Professional		$50.42	$158.38	$303.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.13 / $164.37 / $246.42	Professional		$79.13	$164.37	$246.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.67 / $56.40 / $85.32	Professional	26	$38.67	$56.40	$85.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.34 / $106.43 / $173.52	Professional	TC	$24.34	$106.43	$173.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $136.90 / $209.46 / $430.41	Professional		$136.90	$209.46	$430.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.32 / $64.45 / $173.19	Professional	26	$44.32	$64.45	$173.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.90 / $138.38 / $283.54	Professional	TC	$91.90	$138.38	$283.54
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 $161.19 / $165.70 / $177.97	Professional		$161.19	$165.70	$177.97
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.85 / $49.39 / $52.38	Professional	26	$48.85	$49.39	$52.38
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $111.80 / $116.84 / $125.61	Professional	TC	$111.80	$116.84	$125.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $59.23 / $186.18	Professional		$32.34	$59.23	$186.18
United Facility/Professional Professional Modifier Low / Median / High Price $65.42 / $138.47 / $245.81	Professional		$65.42	$138.47	$245.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.78 / $53.11 / $101.39	Professional	26	$40.78	$53.11	$101.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.02 / $90.56 / $153.66	Professional	TC	$15.02	$90.56	$153.66