Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $190.55 / $331.13	Facility	26	$112.20	$190.55	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $660.69 / $2,754.23	Professional		$426.58	$660.69	$2,754.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $190.55 / $512.86	Professional	26	$109.65	$190.55	$512.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $446.68 / $912.01	Professional	TC	$302.00	$446.68	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $407.38	Professional		$346.74	$346.74	$407.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $154.88	Professional	26	$81.28	$81.28	$154.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $467.74 / $1,047.13	Professional		$134.90	$467.74	$1,047.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	26	$138.04	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $741.31 / $1,479.11	Professional		$478.63	$741.31	$1,479.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $151.36 / $223.87	Professional	26	$91.20	$151.36	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $588.84 / $1,230.27	Professional	TC	$371.54	$588.84	$1,230.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $1,258.93 / $4,073.80	Professional		$512.86	$1,258.93	$4,073.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $208.93 / $954.99	Professional	26	$128.82	$208.93	$954.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $1,096.48 / $3,311.31	Professional	TC	$416.87	$1,096.48	$3,311.31
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 $562.34 / $575.44 / $616.60	Professional		$562.34	$575.44	$616.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $134.90 / $141.25	Professional	26	$128.82	$134.90	$141.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $446.68 / $478.63	Professional	TC	$426.58	$446.68	$478.63
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 $537.03 / $851.14 / $1,412.54	Professional		$537.03	$851.14	$1,412.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $131.83 / $208.93	Professional	26	$102.33	$131.83	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $676.08 / $1,174.90	Professional	TC	$416.87	$676.08	$1,174.90