Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $100.00 / $186.21	Facility	26	$56.23	$100.00	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $234.42 / $1,445.44	Professional		$117.49	$234.42	$1,445.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $229.09 / $933.25	Professional	26	$58.88	$229.09	$933.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $91.20 / $208.93	Professional	TC	$54.95	$91.20	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $120.23 / $190.55	Professional		$95.50	$120.23	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $60.26 / $83.18	Professional	26	$45.71	$60.26	$83.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $147.91 / $281.84	Professional		$75.86	$147.91	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $186.21 / $281.84	Professional		$123.03	$186.21	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $120.23	Professional	26	$54.95	$83.18	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $100.00 / $177.83	Professional	TC	$64.57	$100.00	$177.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $234.42 / $741.31	Professional		$128.82	$234.42	$741.31
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $97.72 / $794.33	Professional	26	$63.10	$97.72	$794.33
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $123.03 / $794.33	Professional	TC	$69.18	$123.03	$794.33
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 $151.36 / $154.88 / $165.96	Professional		$151.36	$154.88	$165.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $79.43	Professional	26	$74.13	$74.13	$79.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $79.43 / $85.11	Professional	TC	$75.86	$79.43	$85.11
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 $128.82 / $181.97 / $263.03	Professional		$128.82	$181.97	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $77.62 / $112.20	Professional	26	$61.66	$77.62	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $102.33 / $162.18	Professional	TC	$67.61	$102.33	$162.18