Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $102.33 / $281.84	Facility	26	$60.26	$102.33	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $398.11 / $794.33	Professional		$234.42	$398.11	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $100.00 / $162.18	Professional	26	$57.54	$100.00	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $288.40 / $549.54	Professional	TC	$173.78	$288.40	$549.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $42.66 / $42.66	Professional	26	$42.66	$42.66	$42.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $257.04 / $512.86	Professional		$70.79	$257.04	$512.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	26	$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $446.68 / $776.25	Professional		$229.09	$446.68	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $79.43 / $141.25	Professional	26	$47.86	$79.43	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $331.13 / $691.83	Professional	TC	$177.83	$331.13	$691.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $616.60 / $2,570.40	Professional		$257.04	$616.60	$2,570.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $109.65 / $741.31	Professional	26	$67.61	$109.65	$741.31
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $512.86 / $1,995.26	Professional	TC	$199.53	$512.86	$1,995.26
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 $269.15 / $281.84 / $302.00	Professional		$269.15	$281.84	$302.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $69.18 / $74.13	Professional	26	$69.18	$69.18	$74.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $208.93 / $229.09	Professional	TC	$204.17	$208.93	$229.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $436.52 / $758.58	Professional		$245.47	$436.52	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $70.79 / $109.65	Professional	26	$54.95	$70.79	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $346.74 / $676.08	Professional	TC	$190.55	$346.74	$676.08