Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $54.95 / $63.10	Facility	26	$36.31	$54.95	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $218.78	Professional		$64.57	$89.13	$218.78
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $93.33 / $114.82 / $114.82	Professional	25	$93.33	$114.82	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $48.98 / $165.96	Professional	26	$33.88	$48.98	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $43.65 / $81.28	Professional	TC	$22.91	$43.65	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $104.71	Professional		$66.07	$83.18	$104.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $40.74 / $48.98	Professional	26	$31.62	$40.74	$48.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $75.86 / $154.88	Professional		$39.81	$75.86	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $97.72 / $147.91	Professional		$72.44	$97.72	$147.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $52.48 / $83.18	Professional	26	$38.02	$52.48	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $47.86 / $75.86	Professional	TC	$25.70	$47.86	$75.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $123.03 / $467.74	Professional		$74.13	$123.03	$467.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $56.23 / $173.78	Professional	26	$36.31	$56.23	$173.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $52.48 / $107.15	Professional	TC	$37.15	$52.48	$107.15
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 $93.33 / $93.33 / $100.00	Professional		$93.33	$93.33	$100.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $46.77	Professional	26	$44.67	$44.67	$46.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $47.86 / $53.70	Professional	TC	$45.71	$47.86	$53.70
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 $58.88 / $85.11 / $128.82	Professional		$58.88	$85.11	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $48.98 / $77.62	Professional	26	$35.48	$48.98	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $35.48 / $58.88	Professional	TC	$20.89	$35.48	$58.88