Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.46 / $73.98 / $80.48	Facility	26	$46.46	$73.98	$80.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.63 / $252.11 / $436.57	Professional		$206.63	$252.11	$436.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.69 / $49.28 / $109.26	Professional	26	$42.69	$49.28	$109.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $215.11 / $376.13	Professional	TC	$162.49	$215.11	$376.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.13 / $199.13 / $199.13	Professional		$199.13	$199.13	$199.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.34 / $38.15 / $66.27	Professional	26	$33.34	$38.15	$66.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.09 / $163.33 / $449.53	Professional		$50.09	$163.33	$449.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $248.48 / $349.46 / $576.82	Professional		$248.48	$349.46	$576.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.70 / $61.42 / $92.48	Professional	26	$44.70	$61.42	$92.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.77 / $289.48 / $489.18	Professional	TC	$201.77	$289.48	$489.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $265.86 / $383.88 / $726.02	Professional		$265.86	$383.88	$726.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.68 / $69.09 / $271.70	Professional	26	$49.68	$69.09	$271.70
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $215.14 / $296.23 / $558.34	Professional	TC	$215.14	$296.23	$558.34
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 $299.23 / $308.83 / $332.70	Professional		$299.23	$308.83	$332.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.50 / $55.51 / $58.71	Professional	26	$54.50	$55.51	$58.71
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $243.74 / $254.35 / $273.99	Professional	TC	$243.74	$254.35	$273.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $61.42 / $348.05	Professional		$32.34	$61.42	$348.05
United Facility/Professional Professional Modifier Low / Median / High Price $265.85 / $377.29 / $574.96	Professional		$265.85	$377.29	$574.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.09 / $59.93 / $101.98	Professional	26	$44.09	$59.93	$101.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $225.43 / $316.75 / $499.97	Professional	TC	$225.43	$316.75	$499.97