Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.48 / $136.60 / $163.26	Facility	26	$88.48	$136.60	$163.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.12 / $385.88 / $676.32	Professional		$251.12	$385.88	$676.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.65 / $103.29 / $378.25	Professional	26	$75.65	$103.29	$378.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.48 / $310.16 / $386.24	Professional	TC	$170.48	$310.16	$386.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.27 / $133.11 / $282.97	Professional		$79.27	$133.11	$282.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.64 / $78.69 / $112.14	Professional	26	$60.64	$78.69	$112.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.96 / $325.42 / $623.82	Professional		$103.96	$325.42	$623.82
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 $267.48 / $435.43 / $834.27	Professional		$267.48	$435.43	$834.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.14 / $112.49 / $172.63	Professional	26	$69.14	$112.49	$172.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.06 / $308.64 / $662.97	Professional	TC	$190.06	$308.64	$662.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $314.58 / $477.58 / $1,770.20	Professional		$314.58	$477.58	$1,770.20
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 $217.64 / $335.24 / $1,323.03	Professional	TC	$217.64	$335.24	$1,323.03
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 $331.18 / $338.70 / $365.21	Professional		$331.18	$338.70	$365.21
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 $228.77 / $238.65 / $257.20	Professional	TC	$228.77	$238.65	$257.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $110.28 / $338.48	Professional		$32.34	$110.28	$338.48
United Facility/Professional Professional Modifier Low / Median / High Price $294.98 / $481.58 / $792.55	Professional		$294.98	$481.58	$792.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.03 / $107.40 / $169.70	Professional	26	$85.03	$107.40	$169.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $209.33 / $330.02 / $630.24	Professional	TC	$209.33	$330.02	$630.24