Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.78 / $38.69 / $40.89	Facility	26	$22.78	$38.69	$40.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.43 / $128.43 / $261.70	Professional		$108.43	$128.43	$261.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.93 / $24.50 / $47.15	Professional	26	$15.93	$24.50	$47.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.66 / $106.95 / $187.00	Professional	TC	$91.66	$106.95	$187.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $72.50 / $115.60	Professional		$72.20	$72.50	$115.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.78 / $20.22 / $28.24	Professional	26	$16.78	$20.22	$28.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.10 / $84.50 / $215.41	Professional		$26.10	$84.50	$215.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.15 / $171.90 / $270.64	Professional		$121.15	$171.90	$270.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $30.12 / $43.34	Professional	26	$17.57	$30.12	$43.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.92 / $141.13 / $232.84	Professional	TC	$97.92	$141.13	$232.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $132.36 / $187.85 / $426.03	Professional		$132.36	$187.85	$426.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.08 / $34.90 / $111.98	Professional	26	$24.08	$34.90	$111.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.18 / $151.01 / $314.05	Professional	TC	$109.18	$151.01	$314.05
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 $143.38 / $146.61 / $159.61	Professional		$143.38	$146.61	$159.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.22 / $28.72 / $30.59	Professional	26	$27.22	$28.72	$30.59
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $114.67 / $119.39 / $129.03	Professional	TC	$114.67	$119.39	$129.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $32.34 / $166.98	Professional		$32.00	$32.34	$166.98
United Facility/Professional Professional Modifier Low / Median / High Price $131.21 / $185.67 / $270.11	Professional		$131.21	$185.67	$270.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.77 / $28.63 / $52.08	Professional	26	$17.77	$28.63	$52.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.31 / $157.59 / $244.45	Professional	TC	$105.31	$157.59	$244.45