Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.53 / $151.27 / $198.97	Facility	26	$90.53	$151.27	$198.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.51 / $475.00 / $800.32	Professional		$354.51	$475.00	$800.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.66 / $140.00 / $208.22	Professional	26	$89.66	$140.00	$208.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $262.50 / $335.00 / $493.56	Professional	TC	$262.50	$335.00	$493.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.87 / $71.69 / $139.62	Professional	26	$62.87	$71.69	$139.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.41 / $381.94 / $748.86	Professional		$106.41	$381.94	$748.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.07 / $112.07 / $112.07	Facility	26	$112.07	$112.07	$112.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.45 / $526.38 / $853.23	Professional		$339.45	$526.38	$853.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.34 / $119.04 / $179.32	Professional	26	$72.34	$119.04	$179.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $249.86 / $388.79 / $689.71	Professional	TC	$249.86	$388.79	$689.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $371.94 / $591.73 / $2,609.03	Professional		$371.94	$591.73	$2,609.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.04 / $145.28 / $759.30	Professional	26	$102.04	$145.28	$759.30
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $287.00 / $450.20 / $2,062.15	Professional	TC	$287.00	$450.20	$2,062.15
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 $397.55 / $407.77 / $439.57	Professional		$397.55	$407.77	$439.57
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.58 / $104.92 / $110.54	Professional	26	$102.58	$104.92	$110.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $292.63 / $305.19 / $329.04	Professional	TC	$292.63	$305.19	$329.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $115.64 / $459.86	Professional		$32.34	$115.64	$459.86
United Facility/Professional Professional Modifier Low / Median / High Price $387.20 / $569.33 / $843.72	Professional		$387.20	$569.33	$843.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.03 / $109.34 / $180.72	Professional	26	$87.03	$109.34	$180.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.45 / $428.93 / $717.72	Professional	TC	$295.45	$428.93	$717.72