Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.14 / $107.58 / $118.50	Facility	26	$64.14	$107.58	$118.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.25 / $252.85 / $406.55	Professional		$198.25	$252.85	$406.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.56 / $64.14 / $107.58	Professional	26	$54.56	$64.14	$107.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.16 / $176.03 / $325.77	Professional	TC	$138.16	$176.03	$325.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $55.37 / $60.17 / $71.68	Professional	26	$55.37	$60.17	$71.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $231.89 / $407.95	Professional		$75.31	$231.89	$407.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.06 / $78.06 / $78.06	Facility	26	$78.06	$78.06	$78.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.50 / $324.19 / $603.11	Professional		$201.50	$324.19	$603.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.64 / $82.50 / $125.44	Professional	26	$50.64	$82.50	$125.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.19 / $231.97 / $478.44	Professional	TC	$138.19	$231.97	$478.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $225.90 / $350.23 / $1,446.72	Professional		$225.90	$350.23	$1,446.72
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.20 / $102.67 / $514.21	Professional	26	$72.20	$102.67	$514.21
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $158.74 / $249.00 / $1,016.79	Professional	TC	$158.74	$249.00	$1,016.79
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 $235.99 / $241.24 / $260.17	Professional		$235.99	$241.24	$260.17
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.34 / $74.15 / $78.22	Professional	26	$72.34	$74.15	$78.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $161.85 / $168.90 / $181.94	Professional	TC	$161.85	$168.90	$181.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $81.83 / $272.18	Professional		$32.34	$81.83	$272.18
United Facility/Professional Professional Modifier Low / Median / High Price $232.78 / $374.01 / $571.11	Professional		$232.78	$374.01	$571.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.44 / $78.52 / $144.66	Professional	26	$62.44	$78.52	$144.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $166.30 / $291.58 / $441.32	Professional	TC	$166.30	$291.58	$441.32