Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.95 / $124.62 / $174.71	Facility	26	$79.95	$124.62	$174.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.72 / $475.00 / $999.63	Professional		$348.72	$475.00	$999.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.43 / $127.28 / $267.51	Professional	26	$74.43	$127.28	$267.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $265.18 / $335.00 / $641.41	Professional	TC	$265.18	$335.00	$641.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.71 / $223.21 / $430.50	Professional		$158.71	$223.21	$430.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.95 / $84.38 / $94.93	Professional	26	$52.95	$84.38	$94.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $315.35 / $739.69	Professional		$88.00	$315.35	$739.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.62 / $111.62 / $111.62	Facility	26	$111.62	$111.62	$111.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.29 / $558.53 / $1,276.00	Professional		$335.29	$558.53	$1,276.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.00 / $103.17 / $174.13	Professional	26	$61.00	$103.17	$174.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $261.32 / $441.19 / $1,114.59	Professional	TC	$261.32	$441.19	$1,114.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $368.50 / $586.25 / $3,488.82	Professional		$368.50	$586.25	$3,488.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.38 / $123.06 / $822.27	Professional	26	$84.38	$123.06	$822.27
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $300.17 / $470.86 / $2,889.40	Professional	TC	$300.17	$470.86	$2,889.40
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 $392.68 / $403.82 / $435.50	Professional		$392.68	$403.82	$435.50
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.54 / $86.62 / $91.42	Professional	26	$84.54	$86.62	$91.42
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $306.06 / $319.27 / $344.10	Professional	TC	$306.06	$319.27	$344.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $95.64 / $455.60	Professional		$32.34	$95.64	$455.60
United Facility/Professional Professional Modifier Low / Median / High Price $374.33 / $648.53 / $1,191.66	Professional		$374.33	$648.53	$1,191.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.00 / $99.24 / $155.88	Professional	26	$76.00	$99.24	$155.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $301.35 / $517.70 / $1,033.51	Professional	TC	$301.35	$517.70	$1,033.51