Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.72 / $72.20 / $79.79	Facility	26	$43.72	$72.20	$79.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $124.19 / $352.56	Professional		$84.00	$124.19	$352.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.08 / $54.47 / $144.41	Professional	26	$41.08	$54.47	$144.41
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $172.62 / $299.14 / $598.30	Professional	50	$172.62	$299.14	$598.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.92 / $51.12 / $75.73	Professional	TC	$39.92	$51.12	$75.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.86 / $107.15 / $131.53	Professional		$83.86	$107.15	$131.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.08 / $51.11 / $62.88	Professional	26	$40.08	$51.11	$62.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.39 / $87.83 / $142.72	Professional		$49.39	$87.83	$142.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.51 / $50.51 / $50.51	Facility	26	$50.51	$50.51	$50.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.91 / $130.22 / $206.80	Professional		$94.91	$130.22	$206.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.35 / $62.73 / $98.28	Professional	26	$46.35	$62.73	$98.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.83 / $65.67 / $104.00	Professional	TC	$46.83	$65.67	$104.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $93.78 / $139.76 / $405.82	Professional		$93.78	$139.76	$405.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.25 / $63.21 / $173.00	Professional	26	$44.25	$63.21	$173.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.71 / $68.09 / $127.97	Professional	TC	$47.71	$68.09	$127.97
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 $111.15 / $113.44 / $121.12	Professional		$111.15	$113.44	$121.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.21 / $54.29 / $57.89	Professional	26	$49.21	$54.29	$57.89
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.75 / $56.38 / $63.23	Professional	TC	$53.75	$56.38	$63.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $42.14 / $119.70	Professional		$32.34	$42.14	$119.70
United Facility/Professional Professional Modifier Low / Median / High Price $86.85 / $124.31 / $195.93	Professional		$86.85	$124.31	$195.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.97 / $65.14 / $102.10	Professional	26	$44.97	$65.14	$102.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.74 / $60.48 / $99.72	Professional	TC	$43.74	$60.48	$99.72