Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.02 / $59.86 / $98.19	Facility	26	$41.02	$59.86	$98.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.12 / $85.33 / $179.45	Professional		$62.12	$85.33	$179.45
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $113.88 / $113.88 / $113.88	Professional	25	$113.88	$113.88	$113.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.56 / $43.04 / $166.00	Professional	26	$35.56	$43.04	$166.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $43.19 / $71.81	Professional	TC	$23.23	$43.19	$71.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.31 / $85.31 / $89.84	Professional		$85.31	$85.31	$89.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.10 / $43.18 / $48.57	Professional	26	$43.10	$43.18	$48.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $75.86 / $156.96	Professional		$39.90	$75.86	$156.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.33 / $100.54 / $150.80	Professional		$74.33	$100.54	$150.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.79 / $53.22 / $83.63	Professional	26	$37.79	$53.22	$83.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.49 / $48.80 / $77.33	Professional	TC	$27.49	$48.80	$77.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.34 / $112.33 / $345.40	Professional		$77.34	$112.33	$345.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.08 / $53.97 / $147.63	Professional	26	$36.08	$53.97	$147.63
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.57 / $55.10 / $103.38	Professional	TC	$38.57	$55.10	$103.38
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 $92.42 / $93.96 / $100.54	Professional		$92.42	$93.96	$100.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.33 / $44.67 / $46.77	Professional	26	$44.33	$44.67	$46.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.69 / $47.75 / $53.76	Professional	TC	$45.69	$47.75	$53.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $44.26 / $105.18	Professional		$32.34	$44.26	$105.18
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $84.18 / $137.63	Professional		$58.88	$84.18	$137.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.14 / $48.70 / $80.55	Professional	26	$35.14	$48.70	$80.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $35.22 / $61.97	Professional	TC	$20.14	$35.22	$61.97