Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.21 / $151.47 / $211.43	Facility	26	$90.21	$151.47	$211.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.74 / $425.00 / $600.00	Professional		$279.74	$425.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.34 / $129.09 / $197.54	Professional	26	$88.34	$129.09	$197.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $198.98 / $299.00 / $433.05	Professional	TC	$198.98	$299.00	$433.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.78 / $163.78 / $163.78	Professional		$163.78	$163.78	$163.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $64.37 / $84.04	Professional	26	$62.17	$64.37	$84.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.64 / $303.98 / $561.41	Professional		$107.64	$303.98	$561.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.82 / $110.82 / $110.82	Facility	26	$110.82	$110.82	$110.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.81 / $455.91 / $904.14	Professional		$274.81	$455.91	$904.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.75 / $118.47 / $176.56	Professional	26	$71.75	$118.47	$176.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $187.15 / $319.08 / $716.83	Professional	TC	$187.15	$319.08	$716.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $310.13 / $482.30 / $2,389.08	Professional		$310.13	$482.30	$2,389.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.40 / $146.19 / $848.21	Professional	26	$102.40	$146.19	$848.21
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $214.98 / $337.22 / $1,911.57	Professional	TC	$214.98	$337.22	$1,911.57
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 $324.77 / $330.99 / $358.28	Professional		$324.77	$330.99	$358.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.40 / $105.59 / $111.83	Professional	26	$102.40	$105.59	$111.83
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $219.19 / $228.59 / $246.45	Professional	TC	$219.19	$228.59	$246.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $116.99 / $374.82	Professional		$32.34	$116.99	$374.82
United Facility/Professional Professional Modifier Low / Median / High Price $315.16 / $533.32 / $881.99	Professional		$315.16	$533.32	$881.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.88 / $110.80 / $171.46	Professional	26	$86.88	$110.80	$171.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $221.81 / $371.92 / $667.84	Professional	TC	$221.81	$371.92	$667.84