Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.43 / $70.87 / $70.87	Facility	26	$45.43	$70.87	$70.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.98 / $84.97 / $119.53	Professional		$70.98	$84.97	$119.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $43.71 / $61.63	Professional	26	$38.81	$43.71	$61.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.59 / $41.09 / $57.90	Professional	TC	$31.59	$41.09	$57.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.19 / $72.42 / $90.86	Professional		$66.19	$72.42	$90.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.26 / $83.99 / $133.91	Professional		$48.26	$83.99	$133.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	26	$50.00	$50.00	$50.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.25 / $116.81 / $177.16	Professional		$68.25	$116.81	$177.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.68 / $62.01 / $97.93	Professional	26	$44.68	$62.01	$97.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.60 / $57.31 / $81.50	Professional	TC	$25.60	$57.31	$81.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $83.55 / $121.74 / $232.27	Professional		$83.55	$121.74	$232.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.18 / $64.62 / $163.63	Professional	26	$45.18	$64.62	$163.63
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.82 / $55.62 / $103.22	Professional	TC	$33.82	$55.62	$103.22
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 $103.44 / $104.81 / $112.49	Professional		$103.44	$104.81	$112.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.16 / $53.78 / $56.58	Professional	26	$53.16	$53.78	$56.58
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.67 / $51.65 / $55.91	Professional	TC	$49.67	$51.65	$55.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $41.37 / $117.68	Professional		$32.34	$41.37	$117.68
United Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $102.48 / $176.89	Professional		$76.45	$102.48	$176.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.42 / $59.13 / $99.57	Professional	26	$42.42	$59.13	$99.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.32 / $49.12 / $80.16	Professional	TC	$31.32	$49.12	$80.16