Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.54 / $60.09 / $95.71	Facility	26	$35.54	$60.09	$95.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.05 / $154.60 / $301.45	Professional		$134.05	$154.60	$301.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.20 / $48.52 / $84.08	Professional	26	$32.20	$48.52	$84.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.82 / $119.06 / $232.16	Professional	TC	$96.82	$119.06	$232.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.39 / $36.81 / $47.74	Professional	26	$18.39	$36.81	$47.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.36 / $171.96 / $269.33	Professional		$45.36	$171.96	$269.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.01 / $86.62 / $285.85	Professional		$60.01	$86.62	$285.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.62 / $26.81 / $68.63	Professional	26	$19.62	$26.81	$68.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.20 / $66.17 / $218.37	Professional	TC	$33.20	$66.17	$218.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $162.19 / $243.27 / $419.61	Professional		$162.19	$243.27	$419.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.16 / $66.72 / $166.36	Professional	26	$43.16	$66.72	$166.36
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $94.17 / $165.43 / $264.68	Professional	TC	$94.17	$165.43	$264.68
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 $204.04 / $210.86 / $225.21	Professional		$204.04	$210.86	$225.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.01 / $51.23 / $53.17	Professional	26	$51.01	$51.23	$53.17
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $153.02 / $159.63 / $172.04	Professional	TC	$153.02	$159.63	$172.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $55.62 / $235.61	Professional		$32.34	$55.62	$235.61
United Facility/Professional Professional Modifier Low / Median / High Price $110.44 / $171.67 / $257.68	Professional		$110.44	$171.67	$257.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.37 / $47.57 / $71.31	Professional	26	$28.37	$47.57	$71.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.48 / $115.78 / $201.64	Professional	TC	$81.48	$115.78	$201.64