Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.96 / $66.37 / $73.06	Facility	26	$47.96	$66.37	$73.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.41 / $87.15 / $156.78	Professional		$66.41	$87.15	$156.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.47 / $47.96 / $88.09	Professional	26	$41.47	$47.96	$88.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.98 / $40.96 / $71.43	Professional	TC	$23.98	$40.96	$71.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.54 / $82.54 / $90.40	Professional		$82.54	$82.54	$90.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.68 / $48.68 / $48.68	Professional	26	$48.68	$48.68	$48.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.99 / $85.16 / $159.75	Professional		$44.99	$85.16	$159.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.14 / $104.52 / $160.16	Professional		$78.14	$104.52	$160.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.43 / $59.17 / $92.36	Professional	26	$42.43	$59.17	$92.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.39 / $47.02 / $71.14	Professional	TC	$28.39	$47.02	$71.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $78.61 / $114.31 / $345.40	Professional		$78.61	$114.31	$345.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.57 / $60.65 / $171.22	Professional	26	$40.57	$60.65	$171.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.10 / $51.35 / $211.13	Professional	TC	$35.10	$51.35	$211.13
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 $94.06 / $95.06 / $102.19	Professional		$94.06	$95.06	$102.19
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 $43.91 / $45.62 / $49.45	Professional	TC	$43.91	$45.62	$49.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $47.29 / $106.91	Professional		$32.34	$47.29	$106.91
United Facility/Professional Professional Modifier Low / Median / High Price $60.15 / $89.15 / $143.21	Professional		$60.15	$89.15	$143.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $55.65 / $94.12	Professional	26	$38.90	$55.65	$94.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.53 / $34.14 / $57.32	Professional	TC	$20.53	$34.14	$57.32