Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.07 / $103.29 / $113.25	Facility	26	$61.07	$103.29	$113.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.62 / $333.88 / $468.38	Professional		$228.62	$333.88	$468.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $61.24 / $115.69	Professional	26	$52.46	$61.24	$115.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.44 / $253.87 / $362.21	Professional	TC	$170.44	$253.87	$362.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.97 / $188.20 / $204.88	Professional		$149.97	$188.20	$204.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.21 / $43.54 / $75.73	Professional	26	$42.21	$43.54	$75.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.04 / $258.75 / $515.35	Professional		$72.04	$258.75	$515.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.23 / $75.23 / $75.23	Facility	26	$75.23	$75.23	$75.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.97 / $380.66 / $610.72	Professional		$244.97	$380.66	$610.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.65 / $79.44 / $119.98	Professional	26	$48.65	$79.44	$119.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.57 / $294.31 / $501.29	Professional	TC	$184.57	$294.31	$501.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $286.64 / $444.10 / $1,505.50	Professional		$286.64	$444.10	$1,505.50
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.06 / $98.42 / $458.94	Professional	26	$69.06	$98.42	$458.94
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $222.68 / $349.30 / $1,116.35	Professional	TC	$222.68	$349.30	$1,116.35
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 $298.12 / $307.01 / $329.90	Professional		$298.12	$307.01	$329.90
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.70 / $71.08 / $74.83	Professional	26	$69.70	$71.08	$74.83
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $227.05 / $237.30 / $255.07	Professional	TC	$227.05	$237.30	$255.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $78.28 / $326.67	Professional		$32.34	$78.28	$326.67
United Facility/Professional Professional Modifier Low / Median / High Price $273.97 / $382.31 / $607.77	Professional		$273.97	$382.31	$607.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.82 / $73.79 / $127.46	Professional	26	$58.82	$73.79	$127.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $211.83 / $313.14 / $500.41	Professional	TC	$211.83	$313.14	$500.41