Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.48 / $133.40 / $163.26	Facility	26	$88.48	$133.40	$163.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.32 / $385.88 / $981.33	Professional		$254.32	$385.88	$981.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.51 / $107.12 / $370.50	Professional	26	$77.51	$107.12	$370.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.48 / $290.08 / $386.24	Professional	TC	$170.48	$290.08	$386.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.72 / $231.29 / $283.32	Professional		$158.72	$231.29	$283.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.64 / $87.22 / $112.14	Professional	26	$60.64	$87.22	$112.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.96 / $325.79 / $612.45	Professional		$103.96	$325.79	$612.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.42 / $108.42 / $108.42	Facility	26	$108.42	$108.42	$108.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $430.32 / $810.98	Professional		$275.00	$430.32	$810.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.79 / $112.15 / $170.64	Professional	26	$69.79	$112.15	$170.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $191.80 / $303.22 / $645.64	Professional	TC	$191.80	$303.22	$645.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $314.95 / $478.14 / $1,833.52	Professional		$314.95	$478.14	$1,833.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.68 / $141.79 / $574.16	Professional	26	$99.68	$141.79	$574.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $221.65 / $336.91 / $1,349.66	Professional	TC	$221.65	$336.91	$1,349.66
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 $331.55 / $339.11 / $365.64	Professional		$331.55	$339.11	$365.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.05 / $102.40 / $107.99	Professional	26	$100.05	$102.40	$107.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.16 / $239.06 / $257.63	Professional	TC	$229.16	$239.06	$257.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $112.98 / $362.26	Professional		$32.34	$112.98	$362.26
United Facility/Professional Professional Modifier Low / Median / High Price $298.89 / $499.20 / $787.10	Professional		$298.89	$499.20	$787.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $107.52 / $170.60	Professional	26	$85.00	$107.52	$170.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $209.69 / $353.17 / $645.30	Professional	TC	$209.69	$353.17	$645.30