Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $104.71 / $181.97	Facility	26	$64.57	$104.71	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $977.24	Professional		$173.78	$281.84	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $93.33 / $234.42	Professional	26	$57.54	$93.33	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $177.83 / $371.54	Professional	TC	$114.82	$177.83	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Professional		$131.83	$131.83	$131.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $57.54 / $93.33	Professional	26	$44.67	$57.54	$93.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $77.62 / $91.20	Professional	TC	$77.62	$77.62	$91.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $186.21 / $331.13	Professional		$75.86	$186.21	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $288.40 / $501.19	Professional		$169.82	$288.40	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $85.11 / $125.89	Professional	26	$51.29	$85.11	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $190.55 / $371.54	Professional	TC	$112.20	$190.55	$371.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $446.68 / $1,548.82	Professional		$199.53	$446.68	$1,548.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $120.23 / $562.34	Professional	26	$72.44	$120.23	$562.34
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $323.59 / $1,096.48	Professional	TC	$134.90	$323.59	$1,096.48
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 $208.93 / $213.80 / $229.09	Professional		$208.93	$213.80	$229.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $74.13 / $79.43	Professional	26	$72.44	$74.13	$79.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $141.25 / $151.36	Professional	TC	$134.90	$141.25	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $281.84 / $478.63	Professional		$186.21	$281.84	$478.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $75.86 / $114.82	Professional	26	$57.54	$75.86	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $194.98 / $363.08	Professional	TC	$120.23	$194.98	$363.08