Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.20 / $41.01 / $42.98	Facility	26	$26.20	$41.01	$42.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.65 / $132.72 / $204.24	Professional		$101.65	$132.72	$204.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $30.10 / $47.38	Professional	26	$23.50	$30.10	$47.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.04 / $103.18 / $163.22	Professional	TC	$69.04	$103.18	$163.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.47 / $47.47 / $47.47	Professional	26	$47.47	$47.47	$47.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $137.13 / $284.10	Professional		$39.90	$137.13	$284.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.11 / $217.86 / $345.92	Professional		$155.11	$217.86	$345.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.20 / $43.56 / $62.46	Professional	26	$26.20	$43.56	$62.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.18 / $173.04 / $295.48	Professional	TC	$126.18	$173.04	$295.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $171.72 / $244.39 / $452.54	Professional		$171.72	$244.39	$452.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.59 / $54.32 / $111.27	Professional	26	$39.59	$54.32	$111.27
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $133.19 / $188.09 / $346.58	Professional	TC	$133.19	$188.09	$346.58
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 $189.11 / $194.12 / $209.79	Professional		$189.11	$194.12	$209.79
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.93 / $44.14 / $46.79	Professional	26	$42.93	$44.14	$46.79
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.97 / $151.19 / $163.01	Professional	TC	$144.97	$151.19	$163.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $48.95 / $197.88	Professional		$32.34	$48.95	$197.88
United Facility/Professional Professional Modifier Low / Median / High Price $157.68 / $231.52 / $346.44	Professional		$157.68	$231.52	$346.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.07 / $37.67 / $67.12	Professional	26	$27.07	$37.67	$67.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $130.96 / $192.12 / $307.44	Professional	TC	$130.96	$192.12	$307.44