Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $107.15 / $281.84	Facility	26	$64.57	$107.15	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $275.42 / $707.95	Professional		$181.97	$275.42	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $77.62 / $154.88	Professional	26	$54.95	$77.62	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $186.21 / $398.11	Professional	TC	$123.03	$186.21	$398.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $54.95 / $60.26	Professional	26	$44.67	$54.95	$60.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $186.21 / $416.87	Professional		$75.86	$186.21	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $87.10 / $87.10	Facility	26	$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $302.00 / $575.44	Professional		$186.21	$302.00	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $85.11 / $131.83	Professional	26	$52.48	$85.11	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $208.93 / $436.52	Professional	TC	$123.03	$208.93	$436.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $467.74 / $1,621.81	Professional		$208.93	$467.74	$1,621.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $123.03 / $588.84	Professional	26	$70.79	$123.03	$588.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $338.84 / $1,148.15	Professional	TC	$144.54	$338.84	$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 $218.78 / $223.87 / $245.47	Professional		$218.78	$223.87	$245.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $74.13 / $77.62	Professional	26	$72.44	$74.13	$77.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $154.88 / $165.96	Professional	TC	$147.91	$154.88	$165.96
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 $194.98 / $323.59 / $524.81	Professional		$194.98	$323.59	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $77.62 / $120.23	Professional	26	$60.26	$77.62	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $229.09 / $426.58	Professional	TC	$131.83	$229.09	$426.58