Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.20 / $43.46 / $75.79	Facility	26	$28.20	$43.46	$75.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $116.87 / $220.75	Professional		$86.29	$116.87	$220.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.42 / $28.20 / $66.58	Professional	26	$23.42	$28.20	$66.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.86 / $88.66 / $165.03	Professional	TC	$62.86	$88.66	$165.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.57 / $26.66 / $37.72	Professional	26	$14.57	$26.66	$37.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.92 / $100.12 / $199.86	Professional		$35.92	$100.12	$199.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.79 / $64.17 / $211.76	Professional		$48.79	$64.17	$211.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.57 / $16.19 / $53.44	Professional	26	$13.57	$16.19	$53.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.22 / $47.98 / $158.32	Professional	TC	$35.22	$47.98	$158.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $128.34 / $192.17 / $360.75	Professional		$128.34	$192.17	$360.75
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $50.20 / $162.25	Professional	26	$34.15	$50.20	$162.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.95 / $135.29 / $251.92	Professional	TC	$93.95	$135.29	$251.92
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 $151.40 / $156.47 / $166.84	Professional		$151.40	$156.47	$166.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.36 / $40.44 / $42.11	Professional	26	$40.36	$40.44	$42.11
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $111.03 / $116.04 / $124.74	Professional	TC	$111.03	$116.04	$124.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $44.05 / $174.54	Professional		$32.34	$44.05	$174.54
United Facility/Professional Professional Modifier Low / Median / High Price $84.54 / $118.92 / $196.38	Professional		$84.54	$118.92	$196.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.65 / $30.66 / $50.39	Professional	26	$21.65	$30.66	$50.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.42 / $88.68 / $143.46	Professional	TC	$62.42	$88.68	$143.46