Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.48 / $66.88 / $73.06	Facility	26	$46.48	$66.88	$73.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.39 / $90.67 / $150.66	Professional		$72.39	$90.67	$150.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.58 / $49.75 / $91.80	Professional	26	$41.58	$49.75	$91.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.17 / $44.25 / $76.17	Professional	TC	$26.17	$44.25	$76.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.46 / $48.46 / $48.46	Professional	26	$48.46	$48.46	$48.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.99 / $85.16 / $167.57	Professional		$44.99	$85.16	$167.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.06 / $110.04 / $165.16	Professional		$83.06	$110.04	$165.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.43 / $60.65 / $96.81	Professional	26	$42.43	$60.65	$96.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.24 / $51.97 / $78.56	Professional	TC	$31.24	$51.97	$78.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $82.58 / $119.91 / $251.37	Professional		$82.58	$119.91	$251.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.57 / $60.65 / $167.49	Professional	26	$40.57	$60.65	$167.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.07 / $55.98 / $105.05	Professional	TC	$38.07	$55.98	$105.05
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 $98.66 / $99.88 / $107.35	Professional		$98.66	$99.88	$107.35
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.44 / $50.14 / $52.74	Professional	26	$49.44	$50.14	$52.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.52 / $50.44 / $54.63	Professional	TC	$48.52	$50.44	$54.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $49.90 / $112.31	Professional		$32.34	$49.90	$112.31
United Facility/Professional Professional Modifier Low / Median / High Price $65.34 / $93.44 / $157.28	Professional		$65.34	$93.44	$157.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.14 / $55.62 / $93.98	Professional	26	$39.14	$55.62	$93.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.62 / $35.99 / $61.44	Professional	TC	$22.62	$35.99	$61.44