Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.45 / $127.10 / $166.84	Facility	26	$75.45	$127.10	$166.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $261.05 / $425.00 / $610.49	Professional		$261.05	$425.00	$610.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.86 / $116.71 / $165.76	Professional	26	$74.86	$116.71	$165.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $510.00	Professional	TC	$187.50	$299.00	$510.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.00 / $52.00 / $53.71	Professional	26	$52.00	$52.00	$53.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.23 / $290.02 / $555.97	Professional		$89.23	$290.02	$555.97
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 $252.01 / $445.38 / $789.59	Professional		$252.01	$445.38	$789.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.87 / $91.65 / $147.00	Professional	26	$54.87	$91.65	$147.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.00 / $319.20 / $681.94	Professional	TC	$177.00	$319.20	$681.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $280.30 / $432.51 / $2,023.13	Professional		$280.30	$432.51	$2,023.13
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.33 / $119.07 / $718.45	Professional	26	$81.33	$119.07	$718.45
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $203.31 / $318.92 / $1,655.51	Professional	TC	$203.31	$318.92	$1,655.51
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 $295.14 / $301.89 / $325.81	Professional		$295.14	$301.89	$325.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.79 / $87.85 / $92.69	Professional	26	$85.79	$87.85	$92.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $207.30 / $216.11 / $233.12	Professional	TC	$207.30	$216.11	$233.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $96.97 / $340.84	Professional		$32.34	$96.97	$340.84
United Facility/Professional Professional Modifier Low / Median / High Price $279.33 / $478.14 / $758.51	Professional		$279.33	$478.14	$758.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.15 / $96.06 / $192.61	Professional	26	$62.15	$96.06	$192.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $202.46 / $355.02 / $650.29	Professional	TC	$202.46	$355.02	$650.29