Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $125.89 / $213.80	Facility	26	$74.13	$125.89	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $524.81 / $1,737.80	Professional		$338.84	$524.81	$1,737.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $134.90 / $407.38	Professional	26	$70.79	$134.90	$407.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $371.54 / $870.96	Professional	TC	$263.03	$371.54	$870.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $66.07 / $95.50	Professional	26	$51.29	$66.07	$95.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $331.13 / $741.31	Professional		$87.10	$331.13	$741.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	26	$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $602.56 / $1,348.96	Professional		$338.84	$602.56	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $104.71 / $173.78	Professional	26	$61.66	$104.71	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $467.74 / $1,202.26	Professional	TC	$275.42	$467.74	$1,202.26
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $1,047.13 / $3,801.89	Professional		$363.08	$1,047.13	$3,801.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $147.91 / $1,000.00	Professional	26	$83.18	$147.91	$1,000.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $977.24 / $2,951.21	Professional	TC	$302.00	$977.24	$2,951.21
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 $389.05 / $407.38 / $436.52	Professional		$389.05	$407.38	$436.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $87.10 / $91.20	Professional	26	$85.11	$87.10	$91.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $316.23 / $346.74	Professional	TC	$309.03	$316.23	$346.74
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 $354.81 / $660.69 / $1,258.93	Professional		$354.81	$660.69	$1,258.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $95.50 / $147.91	Professional	26	$72.44	$95.50	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $524.81 / $1,122.02	Professional	TC	$288.40	$524.81	$1,122.02