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 / $105.34	Facility	26	$56.94	$88.20	$105.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.63 / $268.60 / $458.16	Professional		$160.63	$268.60	$458.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.50 / $69.08 / $222.89	Professional	26	$54.50	$69.08	$222.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.31 / $169.77 / $287.80	Professional	TC	$103.31	$169.77	$287.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.33 / $107.41 / $121.03	Professional		$73.33	$107.41	$121.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.61 / $50.88 / $72.41	Professional	26	$38.61	$50.88	$72.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.13 / $179.94 / $344.95	Professional		$67.13	$179.94	$344.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.11 / $80.11 / $80.11	Facility	26	$80.11	$80.11	$80.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.56 / $241.61 / $459.39	Professional		$152.56	$241.61	$459.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.30 / $75.09 / $118.43	Professional	26	$45.30	$75.09	$118.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.60 / $159.52 / $327.62	Professional	TC	$97.60	$159.52	$327.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $174.93 / $278.77 / $1,194.54	Professional		$174.93	$278.77	$1,194.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.37 / $93.87 / $478.17	Professional	26	$64.37	$93.87	$478.17
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $114.72 / $179.96 / $847.50	Professional	TC	$114.72	$179.96	$847.50
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 $183.12 / $186.52 / $201.34	Professional		$183.12	$186.52	$201.34
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 $116.97 / $121.81 / $131.61	Professional	TC	$116.97	$121.81	$131.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $72.95 / $210.64	Professional		$32.34	$72.95	$210.64
United Facility/Professional Professional Modifier Low / Median / High Price $168.03 / $284.23 / $430.13	Professional		$168.03	$284.23	$430.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.60 / $78.42 / $117.54	Professional	26	$57.60	$78.42	$117.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.72 / $177.99 / $321.99	Professional	TC	$110.72	$177.99	$321.99