Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.04 / $101.54 / $132.40	Facility	26	$60.04	$101.54	$132.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.91 / $402.08 / $637.78	Professional		$240.91	$402.08	$637.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.04 / $101.54 / $154.00	Professional	26	$60.04	$101.54	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $185.09 / $299.00 / $473.80	Professional	TC	$185.09	$299.00	$473.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.15 / $171.15 / $171.15	Professional		$171.15	$171.15	$171.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.94 / $41.94 / $72.06	Professional	26	$41.94	$41.94	$72.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.81 / $254.30 / $511.96	Professional		$70.81	$254.30	$511.96
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 $232.06 / $411.66 / $774.54	Professional		$232.06	$411.66	$774.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.60 / $78.83 / $142.50	Professional	26	$47.60	$78.83	$142.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.42 / $310.95 / $648.92	Professional	TC	$172.42	$310.95	$648.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $260.70 / $404.72 / $2,148.28	Professional		$260.70	$404.72	$2,148.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.90 / $96.71 / $653.58	Professional	26	$67.90	$96.71	$653.58
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $198.05 / $310.66 / $1,594.00	Professional	TC	$198.05	$310.66	$1,594.00
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 $271.77 / $278.94 / $300.64	Professional		$271.77	$278.94	$300.64
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 $201.93 / $210.48 / $227.10	Professional	TC	$201.93	$210.48	$227.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $75.22 / $314.52	Professional		$32.34	$75.22	$314.52
United Facility/Professional Professional Modifier Low / Median / High Price $260.20 / $465.56 / $728.81	Professional		$260.20	$465.56	$728.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.43 / $74.48 / $116.28	Professional	26	$58.43	$74.48	$116.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.86 / $343.21 / $629.98	Professional	TC	$196.86	$343.21	$629.98