Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $107.15 / $281.84	Facility	26	$64.57	$107.15	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $275.42 / $616.60	Professional		$190.55	$275.42	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $138.04	Professional	26	$52.48	$69.18	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $190.55 / $380.19	Professional	TC	$134.90	$190.55	$380.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $47.86 / $85.11	Professional	26	$44.67	$47.86	$85.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $218.78 / $407.38	Professional		$75.86	$218.78	$407.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $323.59 / $602.56	Professional		$199.53	$323.59	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $85.11 / $125.89	Professional	26	$51.29	$85.11	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $239.88 / $489.78	Professional	TC	$144.54	$239.88	$489.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $537.03 / $1,737.80	Professional		$223.87	$537.03	$1,737.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $575.44	Professional	26	$70.79	$120.23	$575.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $398.11 / $1,258.93	Professional	TC	$162.18	$398.11	$1,258.93
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 $234.42 / $239.88 / $263.03	Professional		$234.42	$239.88	$263.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $74.13 / $77.62	Professional	26	$72.44	$74.13	$77.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $169.82 / $181.97	Professional	TC	$162.18	$169.82	$181.97
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 $218.78 / $354.81 / $575.44	Professional		$218.78	$354.81	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $74.13 / $114.82	Professional	26	$57.54	$74.13	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $269.15 / $478.63	Professional	TC	$158.49	$269.15	$478.63