Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $60.26 / $70.79	Facility	26	$39.81	$60.26	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $263.03	Professional		$70.79	$95.50	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $54.95 / $154.88	Professional	26	$38.90	$54.95	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $40.74 / $75.86	Professional	TC	$23.44	$40.74	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $100.00	Professional		$66.07	$81.28	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $43.65 / $53.70	Professional	26	$35.48	$43.65	$53.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $85.11 / $158.49	Professional		$44.67	$85.11	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $100.00 / $158.49	Professional		$75.86	$100.00	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $58.88 / $93.33	Professional	26	$41.69	$58.88	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $44.67 / $70.79	Professional	TC	$26.92	$44.67	$70.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $407.38	Professional		$75.86	$125.89	$407.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $64.57 / $190.55	Professional	26	$40.74	$64.57	$190.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $51.29 / $309.03	Professional	TC	$33.88	$51.29	$309.03
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 / $95.50 / $102.33	Professional		$93.33	$95.50	$102.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $50.12 / $52.48	Professional	26	$48.98	$50.12	$52.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $45.71 / $48.98	Professional	TC	$43.65	$45.71	$48.98
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 $63.10 / $87.10 / $131.83	Professional		$63.10	$87.10	$131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $53.70 / $85.11	Professional	26	$38.90	$53.70	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.88 / $54.95	Professional	TC	$20.89	$33.88	$54.95