Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $58.88 / $74.13	Facility	26	$40.74	$58.88	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $181.97	Professional		$64.57	$83.18	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $48.98 / $128.82	Professional	26	$33.88	$48.98	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $38.02 / $69.18	Professional	TC	$22.39	$38.02	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $63.10 / $87.10	Professional		$61.66	$63.10	$87.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $38.90 / $44.67	Professional	26	$31.62	$38.90	$44.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $74.13 / $144.54	Professional		$39.81	$74.13	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $93.33 / $151.36	Professional		$66.07	$93.33	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $53.70 / $91.20	Professional	26	$37.15	$53.70	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $42.66 / $66.07	Professional	TC	$25.12	$42.66	$66.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $114.82 / $223.87	Professional		$69.18	$114.82	$223.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $47.86 / $141.25	Professional	26	$33.11	$47.86	$141.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $43.65 / $66.07	Professional	TC	$30.20	$43.65	$66.07
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 $85.11 / $85.11 / $93.33	Professional		$85.11	$85.11	$93.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $43.65 / $46.77	Professional	26	$39.81	$43.65	$46.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $40.74 / $45.71	Professional	TC	$38.90	$40.74	$45.71
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 $60.26 / $81.28 / $123.03	Professional		$60.26	$81.28	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $50.12 / $77.62	Professional	26	$35.48	$50.12	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $31.62 / $51.29	Professional	TC	$20.42	$31.62	$51.29