Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.08 / $124.06 / $129.63	Facility	26	$74.08	$124.06	$129.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.51 / $453.80 / $600.00	Professional		$282.51	$453.80	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.45 / $114.82 / $154.00	Professional	26	$73.45	$114.82	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $209.06 / $305.00 / $433.05	Professional	TC	$209.06	$305.00	$433.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.78 / $197.53 / $269.02	Professional		$177.78	$197.53	$269.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.48 / $64.48 / $92.46	Professional	26	$64.48	$64.48	$92.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.58 / $307.66 / $589.78	Professional		$87.58	$307.66	$589.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.61 / $90.61 / $90.61	Facility	26	$90.61	$90.61	$90.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.33 / $420.56 / $758.39	Professional		$267.33	$420.56	$758.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.54 / $97.39 / $147.31	Professional	26	$58.54	$97.39	$147.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $193.70 / $308.20 / $624.89	Professional	TC	$193.70	$308.20	$624.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $300.01 / $465.82 / $2,434.28	Professional		$300.01	$465.82	$2,434.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.98 / $119.41 / $586.29	Professional	26	$83.98	$119.41	$586.29
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $222.50 / $349.02 / $1,889.08	Professional	TC	$222.50	$349.02	$1,889.08
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 $313.08 / $320.77 / $346.03	Professional		$313.08	$320.77	$346.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.14 / $86.24 / $90.97	Professional	26	$84.14	$86.24	$90.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $226.86 / $236.64 / $255.06	Professional	TC	$226.86	$236.64	$255.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $95.17 / $362.00	Professional		$32.34	$95.17	$362.00
United Facility/Professional Professional Modifier Low / Median / High Price $310.62 / $460.07 / $745.72	Professional		$310.62	$460.07	$745.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.36 / $91.86 / $142.60	Professional	26	$72.36	$91.86	$142.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.98 / $379.95 / $590.21	Professional	TC	$234.98	$379.95	$590.21