Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $104.71 / $165.96	Facility	26	$56.23	$104.71	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $295.12 / $724.44	Professional		$181.97	$295.12	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $91.20 / $239.88	Professional	26	$52.48	$91.20	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $199.53 / $446.68	Professional	TC	$125.89	$199.53	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $131.83	Professional		$128.82	$128.82	$131.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $50.12 / $74.13	Professional	26	$39.81	$50.12	$74.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $213.80 / $407.38	Professional		$67.61	$213.80	$407.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $85.11 / $85.11	Facility	26	$85.11	$85.11	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $316.23 / $562.34	Professional		$194.98	$316.23	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $79.43 / $120.23	Professional	26	$46.77	$79.43	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $218.78 / $436.52	Professional	TC	$131.83	$218.78	$436.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $407.38 / $1,479.11	Professional		$204.17	$407.38	$1,479.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $114.82 / $416.87	Professional	26	$63.10	$114.82	$416.87
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $295.12 / $1,148.15	Professional	TC	$147.91	$295.12	$1,148.15
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 $213.80 / $218.78 / $239.88	Professional		$213.80	$218.78	$239.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $66.07 / $69.18	Professional	26	$64.57	$66.07	$69.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $154.88 / $169.82	Professional	TC	$151.36	$154.88	$169.82
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 $213.80 / $323.59 / $489.78	Professional		$213.80	$323.59	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $74.13 / $114.82	Professional	26	$54.95	$74.13	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $251.19 / $389.05	Professional	TC	$151.36	$251.19	$389.05