Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $60.26 / $97.72	Facility	26	$28.18	$60.26	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $239.88	Professional		$85.11	$114.82	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $39.81 / $147.91	Professional	26	$23.44	$39.81	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $87.10 / $165.96	Professional	TC	$63.10	$87.10	$165.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $30.90 / $35.48	Professional	26	$18.62	$30.90	$35.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $100.00 / $199.53	Professional		$36.31	$100.00	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $67.61 / $208.93	Professional		$48.98	$67.61	$208.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.98 / $53.70	Professional	26	$13.49	$16.98	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $51.29 / $154.88	Professional	TC	$35.48	$51.29	$154.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $199.53 / $398.11	Professional		$128.82	$199.53	$398.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $50.12 / $190.55	Professional	26	$33.88	$50.12	$190.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $134.90 / $257.04	Professional	TC	$93.33	$134.90	$257.04
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 $40.74 / $40.74 / $41.69	Professional	26	$40.74	$40.74	$41.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $114.82 / $125.89	Professional	TC	$112.20	$114.82	$125.89
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 $85.11 / $112.20 / $181.97	Professional		$85.11	$112.20	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $29.51 / $50.12	Professional	26	$21.88	$29.51	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $77.62 / $144.54	Professional	TC	$60.26	$77.62	$144.54