Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.39 / $98.72 / $142.10	Facility	26	$60.39	$98.72	$142.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.48 / $397.67 / $600.00	Professional		$228.48	$397.67	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $111.15 / $298.80	Professional	26	$60.39	$111.15	$298.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.34 / $295.14 / $440.00	Professional	TC	$176.34	$295.14	$440.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.84 / $221.54 / $256.80	Professional		$141.84	$221.54	$256.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.45 / $67.90 / $76.38	Professional	26	$40.45	$67.90	$76.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.81 / $253.12 / $485.23	Professional		$70.81	$253.12	$485.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.02 / $74.02 / $74.02	Facility	26	$74.02	$74.02	$74.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.95 / $389.87 / $755.48	Professional		$219.95	$389.87	$755.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.80 / $78.83 / $126.00	Professional	26	$47.80	$78.83	$126.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.30 / $289.16 / $648.92	Professional	TC	$160.30	$289.16	$648.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $246.93 / $383.30 / $1,995.23	Professional		$246.93	$383.30	$1,995.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.90 / $96.71 / $551.61	Professional	26	$67.90	$96.71	$551.61
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $184.14 / $288.83 / $1,680.11	Professional	TC	$184.14	$288.83	$1,680.11
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 $257.60 / $264.06 / $284.74	Professional		$257.60	$264.06	$284.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.45 / $69.84 / $73.55	Professional	26	$68.45	$69.84	$73.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $187.75 / $195.60 / $211.19	Professional	TC	$187.75	$195.60	$211.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $76.95 / $297.88	Professional		$32.34	$76.95	$297.88
United Facility/Professional Professional Modifier Low / Median / High Price $246.91 / $430.33 / $722.16	Professional		$246.91	$430.33	$722.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.43 / $74.89 / $125.31	Professional	26	$58.43	$74.89	$125.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.95 / $326.22 / $643.65	Professional	TC	$186.95	$326.22	$643.65