Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.94 / $88.20 / $116.95	Facility	26	$56.94	$88.20	$116.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.51 / $316.74 / $527.84	Professional		$184.51	$316.74	$527.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.51 / $66.05 / $145.54	Professional	26	$54.51	$66.05	$145.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $127.36 / $225.45 / $379.63	Professional	TC	$127.36	$225.45	$379.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.00 / $151.63 / $173.78	Professional		$109.00	$151.63	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.63 / $57.20 / $71.84	Professional	26	$36.63	$57.20	$71.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.13 / $212.35 / $407.07	Professional		$67.13	$212.35	$407.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.35 / $85.35 / $85.35	Facility	26	$85.35	$85.35	$85.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.52 / $300.73 / $547.27	Professional		$184.52	$300.73	$547.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.62 / $77.78 / $124.63	Professional	26	$46.62	$77.78	$124.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.04 / $214.46 / $409.99	Professional	TC	$128.04	$214.46	$409.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $206.99 / $329.99 / $1,224.88	Professional		$206.99	$329.99	$1,224.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.37 / $93.87 / $372.44	Professional	26	$64.37	$93.87	$372.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.07 / $230.70 / $927.32	Professional	TC	$147.07	$230.70	$927.32
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 $216.10 / $221.13 / $238.33	Professional		$216.10	$221.13	$238.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.70 / $66.14 / $69.73	Professional	26	$64.70	$66.14	$69.73
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $149.96 / $156.41 / $168.61	Professional	TC	$149.96	$156.41	$168.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $72.95 / $249.33	Professional		$32.34	$72.95	$249.33
United Facility/Professional Professional Modifier Low / Median / High Price $224.67 / $340.50 / $510.88	Professional		$224.67	$340.50	$510.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.74 / $79.84 / $124.62	Professional	26	$57.74	$79.84	$124.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $160.63 / $264.05 / $395.63	Professional	TC	$160.63	$264.05	$395.63