Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $39.81 / $67.61	Facility	26	$26.30	$39.81	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $181.97 / $512.86	Professional		$95.50	$181.97	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $43.65 / $117.49	Professional	26	$22.91	$43.65	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $89.13 / $186.21	Professional	TC	$67.61	$89.13	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $97.72 / $199.53	Professional		$72.44	$97.72	$199.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $28.84 / $45.71	Professional	26	$19.50	$28.84	$45.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $91.20 / $194.98	Professional		$26.92	$91.20	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $138.04 / $213.80	Professional		$97.72	$138.04	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $35.48 / $56.23	Professional	26	$25.70	$35.48	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $104.71 / $173.78	Professional	TC	$75.86	$104.71	$173.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $162.18 / $537.03	Professional		$107.15	$162.18	$537.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $41.69 / $208.93	Professional	26	$26.92	$41.69	$208.93
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $109.65 / $323.59	Professional	TC	$77.62	$109.65	$323.59
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 $114.82 / $117.49 / $125.89	Professional		$114.82	$117.49	$125.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $30.20 / $31.62	Professional	26	$29.51	$30.20	$31.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $87.10 / $95.50	Professional	TC	$85.11	$87.10	$95.50
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 $97.72 / $131.83 / $194.98	Professional		$97.72	$131.83	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.11 / $50.12	Professional	26	$24.55	$33.11	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $97.72 / $144.54	Professional	TC	$70.79	$97.72	$144.54