Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.39 / $102.09 / $142.10	Facility	26	$60.39	$102.09	$142.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.08 / $417.41 / $600.00	Professional		$237.08	$417.41	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $110.00 / $158.31	Professional	26	$60.39	$110.00	$158.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.69 / $299.00 / $433.05	Professional	TC	$176.69	$299.00	$433.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.41 / $163.01 / $282.70	Professional		$130.41	$163.01	$282.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $46.82 / $75.25	Professional	26	$41.69	$46.82	$75.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.22 / $253.87 / $486.67	Professional		$71.22	$253.87	$486.67
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 $220.60 / $391.05 / $758.42	Professional		$220.60	$391.05	$758.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.91 / $78.83 / $126.00	Professional	26	$47.91	$78.83	$126.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.63 / $289.74 / $648.92	Professional	TC	$160.63	$289.74	$648.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $247.68 / $384.46 / $1,786.12	Professional		$247.68	$384.46	$1,786.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.29 / $97.25 / $567.07	Professional	26	$68.29	$97.25	$567.07
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $184.51 / $289.42 / $1,425.14	Professional	TC	$184.51	$289.42	$1,425.14
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 $258.36 / $264.86 / $285.60	Professional		$258.36	$264.86	$285.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.86 / $70.23 / $73.98	Professional	26	$68.86	$70.23	$73.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $188.12 / $196.00 / $211.61	Professional	TC	$188.12	$196.00	$211.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $77.40 / $298.77	Professional		$32.34	$77.40	$298.77
United Facility/Professional Professional Modifier Low / Median / High Price $250.10 / $431.70 / $722.71	Professional		$250.10	$431.70	$722.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.06 / $73.67 / $126.03	Professional	26	$58.06	$73.67	$126.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.54 / $335.62 / $642.90	Professional	TC	$186.54	$335.62	$642.90