Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.58 / $114.04 / $158.83	Facility	26	$67.58	$114.04	$158.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $249.52 / $425.00 / $608.00	Professional		$249.52	$425.00	$608.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.14 / $114.04 / $154.84	Professional	26	$67.14	$114.04	$154.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.65 / $299.00 / $433.05	Professional	TC	$176.65	$299.00	$433.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $205.91 / $217.44 / $232.02	Professional		$205.91	$217.44	$232.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.14 / $84.29 / $90.14	Professional	26	$47.14	$84.29	$90.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.81 / $265.35 / $508.67	Professional		$79.81	$265.35	$508.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.32 / $83.32 / $83.32	Facility	26	$83.32	$83.32	$83.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.57 / $381.89 / $753.03	Professional		$230.57	$381.89	$753.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.14 / $86.36 / $132.66	Professional	26	$53.14	$86.36	$132.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $163.41 / $279.19 / $610.28	Professional	TC	$163.41	$279.19	$610.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $258.95 / $401.12 / $1,977.63	Professional		$258.95	$401.12	$1,977.63
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.52 / $108.92 / $627.14	Professional	26	$76.52	$108.92	$627.14
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $187.69 / $294.42 / $1,611.44	Professional	TC	$187.69	$294.42	$1,611.44
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 $270.04 / $276.80 / $297.97	Professional		$270.04	$276.80	$297.97
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.92 / $78.66 / $82.90	Professional	26	$76.92	$78.66	$82.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $191.37 / $199.88 / $215.06	Professional	TC	$191.37	$199.88	$215.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $86.73 / $311.73	Professional		$32.34	$86.73	$311.73
United Facility/Professional Professional Modifier Low / Median / High Price $262.44 / $448.70 / $716.88	Professional		$262.44	$448.70	$716.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.27 / $82.28 / $148.13	Professional	26	$65.27	$82.28	$148.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.38 / $327.27 / $572.65	Professional	TC	$194.38	$327.27	$572.65