Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.58 / $83.22 / $99.75	Facility	26	$50.58	$83.22	$99.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.13 / $179.96 / $463.79	Professional		$147.13	$179.96	$463.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.59 / $57.92 / $171.88	Professional	26	$49.59	$57.92	$171.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.09 / $118.30 / $225.86	Professional	TC	$98.09	$118.30	$225.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.17 / $67.09 / $75.48	Professional	26	$47.17	$67.09	$75.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.97 / $176.30 / $392.48	Professional		$69.97	$176.30	$392.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.86 / $253.82 / $377.67	Professional		$151.86	$253.82	$377.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.17 / $78.28 / $126.27	Professional	26	$50.17	$78.28	$126.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.29 / $172.97 / $255.29	Professional	TC	$101.29	$172.97	$255.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $176.66 / $264.99 / $896.34	Professional		$176.66	$264.99	$896.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.71 / $86.14 / $357.50	Professional	26	$58.71	$86.14	$357.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $188.60 / $545.57	Professional	TC	$123.03	$188.60	$545.57
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 $208.35 / $211.90 / $229.66	Professional		$208.35	$211.90	$229.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.68 / $69.12 / $72.68	Professional	26	$67.68	$69.12	$72.68
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $139.22 / $144.22 / $156.96	Professional	TC	$139.22	$144.22	$156.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $76.04 / $240.26	Professional		$32.34	$76.04	$240.26
United Facility/Professional Professional Modifier Low / Median / High Price $181.81 / $239.48 / $444.79	Professional		$181.81	$239.48	$444.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.19 / $75.43 / $120.45	Professional	26	$59.19	$75.43	$120.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.02 / $149.35 / $238.55	Professional	TC	$119.02	$149.35	$238.55