Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.60 / $84.88 / $171.01	Facility	26	$55.60	$84.88	$171.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.98 / $176.20 / $738.38	Professional		$111.98	$176.20	$738.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.67 / $100.95 / $895.05	Professional	26	$53.67	$100.95	$895.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.47 / $91.52 / $179.17	Professional	TC	$53.47	$91.52	$179.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.20 / $126.76 / $132.63	Professional		$98.20	$126.76	$132.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.86 / $63.97 / $82.24	Professional	26	$43.86	$63.97	$82.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $148.35 / $284.38	Professional		$76.23	$148.35	$284.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.10 / $190.14 / $278.20	Professional		$128.10	$190.14	$278.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.95 / $85.06 / $129.60	Professional	26	$58.95	$85.06	$129.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.00 / $101.17 / $175.50	Professional	TC	$65.00	$101.17	$175.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $133.10 / $211.69 / $707.88	Professional		$133.10	$211.69	$707.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.01 / $100.75 / $502.74	Professional	26	$67.01	$100.75	$502.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.42 / $111.93 / $502.74	Professional	TC	$72.42	$111.93	$502.74
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 $150.97 / $153.69 / $164.79	Professional		$150.97	$153.69	$164.79
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.27 / $74.84 / $79.20	Professional	26	$74.27	$74.84	$79.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $76.13 / $79.42 / $85.59	Professional	TC	$76.13	$79.42	$85.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $80.98 / $172.39	Professional		$32.34	$80.98	$172.39
United Facility/Professional Professional Modifier Low / Median / High Price $131.29 / $181.01 / $278.19	Professional		$131.29	$181.01	$278.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.27 / $78.66 / $125.60	Professional	26	$62.27	$78.66	$125.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.48 / $105.64 / $160.99	Professional	TC	$67.48	$105.64	$160.99