Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.18 / $89.95 / $148.08	Facility	26	$62.18	$89.95	$148.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.65 / $107.01 / $232.49	Professional		$84.65	$107.01	$232.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.22 / $64.62 / $129.35	Professional	26	$56.22	$64.62	$129.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $44.74 / $75.59	Professional	TC	$26.89	$44.74	$75.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.48 / $101.48 / $111.15	Professional		$101.48	$101.48	$111.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.20 / $74.20 / $95.17	Professional	26	$63.20	$74.20	$95.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.95 / $107.18 / $197.14	Professional		$60.95	$107.18	$197.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.43 / $129.86 / $196.53	Professional		$96.43	$129.86	$196.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.49 / $78.45 / $124.43	Professional	26	$57.49	$78.45	$124.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.42 / $51.84 / $77.95	Professional	TC	$31.42	$51.84	$77.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $96.65 / $141.08 / $398.53	Professional		$96.65	$141.08	$398.53
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.87 / $77.73 / $170.29	Professional	26	$54.87	$77.73	$170.29
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.97 / $55.55 / $106.66	Professional	TC	$38.97	$55.55	$106.66
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 $116.08 / $117.07 / $125.65	Professional		$116.08	$117.07	$125.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.73 / $67.03 / $71.45	Professional	26	$60.73	$67.03	$71.45
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.06 / $48.14 / $54.18	Professional	TC	$46.06	$48.14	$54.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $52.10 / $131.44	Professional		$32.34	$52.10	$131.44
United Facility/Professional Professional Modifier Low / Median / High Price $78.48 / $112.60 / $180.63	Professional		$78.48	$112.60	$180.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.05 / $71.23 / $116.00	Professional	26	$53.05	$71.23	$116.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.74 / $37.31 / $61.87	Professional	TC	$23.74	$37.31	$61.87