Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.46 / $70.28 / $136.16	Facility	26	$48.46	$70.28	$136.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.13 / $158.71 / $377.85	Professional		$129.13	$158.71	$377.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.51 / $49.82 / $99.38	Professional	26	$42.51	$49.82	$99.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.77 / $112.31 / $209.40	Professional	TC	$91.77	$112.31	$209.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.62 / $100.62 / $100.62	Professional		$100.62	$100.62	$100.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.49 / $53.49 / $53.49	Professional	26	$53.49	$53.49	$53.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $132.44 / $271.25	Professional		$47.52	$132.44	$271.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.13 / $202.72 / $294.99	Professional		$135.13	$202.72	$294.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.92 / $61.98 / $93.27	Professional	26	$44.92	$61.98	$93.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.10 / $138.46 / $201.84	Professional	TC	$92.10	$138.46	$201.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.41 / $214.99 / $611.64	Professional		$147.41	$214.99	$611.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.14 / $67.38 / $285.10	Professional	26	$47.14	$67.38	$285.10
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $101.53 / $143.54 / $362.91	Professional	TC	$101.53	$143.54	$362.91
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 $159.71 / $163.33 / $175.70	Professional		$159.71	$163.33	$175.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.39 / $53.08 / $55.71	Professional	26	$52.39	$53.08	$55.71
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $106.63 / $110.94 / $119.99	Professional	TC	$106.63	$110.94	$119.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $58.28 / $183.80	Professional		$32.34	$58.28	$183.80
United Facility/Professional Professional Modifier Low / Median / High Price $135.15 / $202.79 / $321.38	Professional		$135.15	$202.79	$321.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.36 / $60.94 / $98.75	Professional	26	$45.36	$60.94	$98.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.09 / $136.53 / $218.54	Professional	TC	$89.09	$136.53	$218.54