Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.06 / $34.03 / $61.46	Facility	26	$23.06	$34.03	$61.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.22 / $180.90 / $293.52	Professional		$115.22	$180.90	$293.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.80 / $25.45 / $57.29	Professional	26	$18.80	$25.45	$57.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.27 / $149.96 / $237.21	Professional	TC	$92.27	$149.96	$237.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $16.91 / $35.21	Professional	26	$16.82	$16.91	$35.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.82 / $86.21 / $216.86	Professional		$26.82	$86.21	$216.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.69 / $173.27 / $274.01	Professional		$121.69	$173.27	$274.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.46 / $31.92 / $46.87	Professional	26	$22.46	$31.92	$46.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.24 / $141.61 / $234.39	Professional	TC	$98.24	$141.61	$234.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $133.26 / $177.68 / $379.87	Professional		$133.26	$177.68	$379.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.49 / $36.06 / $113.80	Professional	26	$26.49	$36.06	$113.80
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $99.58 / $141.62 / $283.91	Professional	TC	$99.58	$141.62	$283.91
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 $144.37 / $147.15 / $160.90	Professional		$144.37	$147.15	$160.90
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.35 / $29.30 / $31.43	Professional	26	$27.35	$29.30	$31.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $115.06 / $119.80 / $129.44	Professional	TC	$115.06	$119.80	$129.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.88 / $168.33	Professional		$32.34	$32.88	$168.33
United Facility/Professional Professional Modifier Low / Median / High Price $131.37 / $190.05 / $276.17	Professional		$131.37	$190.05	$276.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.00 / $30.26 / $55.91	Professional	26	$22.00	$30.26	$55.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.60 / $154.15 / $246.66	Professional	TC	$104.60	$154.15	$246.66