Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.17 / $34.79 / $41.63	Facility	26	$21.17	$34.79	$41.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.18 / $221.90 / $443.93	Professional		$185.18	$221.90	$443.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.53 / $23.33 / $45.08	Professional	26	$20.53	$23.33	$45.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.65 / $201.28 / $358.87	Professional	TC	$164.65	$201.28	$358.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $24.38 / $27.86	Professional	26	$16.60	$24.38	$27.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.06 / $104.50 / $468.77	Professional		$29.06	$104.50	$468.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.54 / $299.30 / $503.40	Professional		$202.54	$299.30	$503.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.83 / $32.50 / $52.18	Professional	26	$20.83	$32.50	$52.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.47 / $267.83 / $449.27	Professional	TC	$184.47	$267.83	$449.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $210.57 / $310.12 / $996.14	Professional		$210.57	$310.12	$996.14
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.29 / $35.33 / $134.72	Professional	26	$24.29	$35.33	$134.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.29 / $266.77 / $599.12	Professional	TC	$186.29	$266.77	$599.12
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 $248.86 / $257.27 / $277.91	Professional		$248.86	$257.27	$277.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.15 / $28.70 / $30.19	Professional	26	$28.15	$28.70	$30.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $210.57 / $220.16 / $247.73	Professional	TC	$210.57	$220.16	$247.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.58 / $34.13 / $290.74	Professional		$31.58	$34.13	$290.74
United Facility/Professional Professional Modifier Low / Median / High Price $230.44 / $295.81 / $496.00	Professional		$230.44	$295.81	$496.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.66 / $31.14 / $46.48	Professional	26	$24.66	$31.14	$46.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $209.35 / $281.82 / $428.03	Professional	TC	$209.35	$281.82	$428.03