Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $89.13 / $104.71	Facility	26	$58.88	$89.13	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $123.03 / $331.13	Professional		$93.33	$123.03	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $177.83	Professional	26	$57.54	$72.44	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $47.86 / $87.10	Professional	TC	$30.20	$47.86	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $112.20 / $128.82	Professional		$95.50	$112.20	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $83.18	Professional	26	$52.48	$64.57	$83.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $114.82 / $213.80	Professional		$66.07	$114.82	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $208.93	Professional		$102.33	$138.04	$208.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $87.10 / $138.04	Professional	26	$61.66	$87.10	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $53.70 / $83.18	Professional	TC	$34.67	$53.70	$83.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $162.18 / $489.78	Professional		$102.33	$162.18	$489.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $81.28 / $208.93	Professional	26	$56.23	$81.28	$208.93
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $61.66 / $389.05	Professional	TC	$39.81	$61.66	$389.05
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 $125.89 / $125.89 / $134.90	Professional		$125.89	$125.89	$134.90
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $72.44 / $77.62	Professional	26	$66.07	$72.44	$77.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $53.70 / $57.54	Professional	TC	$51.29	$53.70	$57.54
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 $85.11 / $123.03 / $186.21	Professional		$85.11	$123.03	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $79.43 / $125.89	Professional	26	$57.54	$79.43	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $40.74 / $64.57	Professional	TC	$26.92	$40.74	$64.57