Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.75 / $123.41 / $173.01	Facility	26	$73.75	$123.41	$173.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $305.81 / $475.00 / $646.47	Professional		$305.81	$475.00	$646.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.75 / $126.00 / $268.20	Professional	26	$73.75	$126.00	$268.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $233.65 / $335.00 / $472.35	Professional	TC	$233.65	$335.00	$472.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $244.55 / $244.55 / $322.16	Professional		$244.55	$244.55	$322.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.43 / $52.43 / $88.61	Professional	26	$52.43	$52.43	$88.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.18 / $312.29 / $712.51	Professional		$87.18	$312.29	$712.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.39 / $89.39 / $89.39	Facility	26	$89.39	$89.39	$89.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.97 / $525.42 / $853.19	Professional		$339.97	$525.42	$853.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.00 / $95.70 / $146.32	Professional	26	$58.00	$95.70	$146.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $266.72 / $415.63 / $709.72	Professional	TC	$266.72	$415.63	$709.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $373.62 / $594.39 / $2,009.86	Professional		$373.62	$594.39	$2,009.86
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.59 / $118.78 / $482.97	Professional	26	$83.59	$118.78	$482.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $306.37 / $480.58 / $1,633.52	Professional	TC	$306.37	$480.58	$1,633.52
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 $398.16 / $410.07 / $441.55	Professional		$398.16	$410.07	$441.55
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.69 / $85.79 / $90.56	Professional	26	$83.69	$85.79	$90.56
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $312.38 / $326.38 / $350.99	Professional	TC	$312.38	$326.38	$350.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $92.39 / $432.68	Professional		$32.34	$92.39	$432.68
United Facility/Professional Professional Modifier Low / Median / High Price $398.99 / $586.79 / $850.99	Professional		$398.99	$586.79	$850.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.84 / $93.35 / $163.12	Professional	26	$70.84	$93.35	$163.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $324.04 / $472.15 / $707.77	Professional	TC	$324.04	$472.15	$707.77