Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $28.18 / $31.62	Facility	26	$17.38	$28.18	$31.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $87.10 / $407.38	Professional		$54.95	$87.10	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $30.90 / $104.71	Professional	26	$16.98	$30.90	$104.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $199.53 / $199.53	Professional	50	$28.84	$199.53	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $44.67 / $83.18	Professional	TC	$36.31	$44.67	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $67.61 / $87.10	Professional		$51.29	$67.61	$87.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.89 / $24.55	Professional	26	$15.85	$20.89	$24.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $51.29 / $91.20	Professional		$19.95	$51.29	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $125.89	Professional		$60.26	$79.43	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $25.12 / $39.81	Professional	26	$18.62	$25.12	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $54.95 / $87.10	Professional	TC	$40.74	$54.95	$87.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $104.71 / $275.42	Professional		$56.23	$104.71	$275.42
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $28.84 / $107.15	Professional	26	$17.78	$28.84	$107.15
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $57.54 / $134.90	Professional	TC	$38.90	$57.54	$134.90
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 $70.79 / $72.44 / $77.62	Professional		$70.79	$72.44	$77.62
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $22.39 / $23.44	Professional	26	$21.88	$22.39	$23.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $47.86 / $53.70	Professional	TC	$45.71	$47.86	$53.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $32.36 / $33.11	Professional		$26.92	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $117.49	Professional		$57.54	$75.86	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $23.99 / $36.31	Professional	26	$17.38	$23.99	$36.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $52.48 / $81.28	Professional	TC	$38.90	$52.48	$81.28