Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.20 / $129.43 / $211.22	Facility	26	$82.20	$129.43	$211.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $152.09 / $245.66	Professional		$130.08	$152.09	$245.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.61 / $82.55 / $127.41	Professional	26	$71.61	$82.55	$127.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $75.86 / $121.15	Professional	TC	$55.03	$75.86	$121.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $91.49 / $91.49 / $91.49	Professional	26	$91.49	$91.49	$91.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.23 / $157.19 / $251.08	Professional		$88.23	$157.19	$251.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.04 / $91.04 / $91.04	Facility	26	$91.04	$91.04	$91.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.37 / $212.60 / $340.20	Professional		$126.37	$212.60	$340.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.23 / $111.87 / $178.62	Professional	26	$81.23	$111.87	$178.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.78 / $100.95 / $161.35	Professional	TC	$39.78	$100.95	$161.35
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $148.83 / $219.70 / $1,343.52	Professional		$148.83	$219.70	$1,343.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.73 / $118.83 / $765.39	Professional	26	$82.73	$118.83	$765.39
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.88 / $103.12 / $1,070.31	Professional	TC	$59.88	$103.12	$1,070.31
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 $170.53 / $184.26 / $200.63	Professional		$170.53	$184.26	$200.63
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.91 / $96.58 / $103.43	Professional	26	$87.91	$96.58	$103.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $82.63 / $86.49 / $97.21	Professional	TC	$82.63	$86.49	$97.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $56.80 / $198.44	Professional		$32.34	$56.80	$198.44
United Facility/Professional Professional Modifier Low / Median / High Price $131.82 / $200.67 / $358.01	Professional		$131.82	$200.67	$358.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.20 / $107.82 / $181.09	Professional	26	$76.20	$107.82	$181.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.02 / $103.85 / $180.60	Professional	TC	$46.02	$103.85	$180.60