Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $70.79 / $138.04	Facility	26	$48.98	$70.79	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $323.59	Professional		$125.89	$162.18	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $54.95 / $162.18	Professional	26	$40.74	$54.95	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $112.20 / $223.87	Professional	TC	$85.11	$112.20	$223.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $54.95 / $97.72	Professional	26	$43.65	$54.95	$97.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $128.82 / $269.15	Professional		$47.86	$128.82	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $331.13	Professional		$131.83	$199.53	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $61.66 / $100.00	Professional	26	$44.67	$61.66	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $134.90 / $218.78	Professional	TC	$93.33	$134.90	$218.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $245.47 / $616.60	Professional		$147.91	$245.47	$616.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $72.44 / $331.13	Professional	26	$47.86	$72.44	$331.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $162.18 / $426.58	Professional	TC	$102.33	$162.18	$426.58
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 $158.49 / $162.18 / $173.78	Professional		$158.49	$162.18	$173.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $52.48 / $56.23	Professional	26	$52.48	$52.48	$56.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $112.20 / $120.23	Professional	TC	$107.15	$112.20	$120.23
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 $131.83 / $186.21 / $295.12	Professional		$131.83	$186.21	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $57.54 / $87.10	Professional	26	$43.65	$57.54	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $125.89 / $218.78	Professional	TC	$89.13	$125.89	$218.78