Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.64 / $71.11 / $104.19	Facility	26	$45.64	$71.11	$104.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.45 / $150.00 / $253.78	Professional		$89.45	$150.00	$253.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.11 / $60.97 / $131.33	Professional	26	$43.11	$60.97	$131.33
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.11 / $52.38 / $105.16	Professional	52	$44.11	$52.38	$105.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.55 / $85.14 / $164.82	Professional	TC	$45.55	$85.14	$164.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.94 / $56.55 / $61.74	Professional	26	$40.94	$56.55	$61.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.88 / $90.90 / $147.71	Professional		$47.88	$90.90	$147.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.80 / $49.80 / $49.80	Facility	26	$49.80	$49.80	$49.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.58 / $171.64 / $351.75	Professional		$98.58	$171.64	$351.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.68 / $75.51 / $123.79	Professional	26	$45.68	$75.51	$123.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.69 / $94.42 / $215.35	Professional	TC	$52.69	$94.42	$215.35
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.21 / $149.47 / $913.93	Professional		$97.21	$149.47	$913.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.89 / $69.05 / $315.39	Professional	26	$44.89	$69.05	$315.39
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.93 / $82.55 / $519.32	Professional	TC	$51.93	$82.55	$519.32
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 $114.88 / $116.26 / $125.36	Professional		$114.88	$116.26	$125.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.81 / $53.51 / $56.12	Professional	26	$52.81	$53.51	$56.12
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.37 / $63.45 / $69.23	Professional	TC	$61.37	$63.45	$69.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $47.21 / $123.72	Professional		$32.34	$47.21	$123.72
United Facility/Professional Professional Modifier Low / Median / High Price $111.46 / $198.08 / $310.77	Professional		$111.46	$198.08	$310.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.53 / $74.36 / $117.77	Professional	26	$44.53	$74.36	$117.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.15 / $118.84 / $185.79	Professional	TC	$67.15	$118.84	$185.79