Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.80 / $146.63 / $205.59	Facility	26	$87.80	$146.63	$205.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.52 / $425.00 / $600.00	Professional		$282.52	$425.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.19 / $120.30 / $154.00	Professional	26	$85.19	$120.30	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.99 / $284.23 / $433.05	Professional	TC	$199.99	$284.23	$433.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.33 / $162.33 / $162.33	Professional		$162.33	$162.33	$162.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.90 / $65.67 / $80.34	Professional	26	$59.90	$65.67	$80.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.73 / $297.04 / $556.42	Professional		$102.73	$297.04	$556.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.20 / $107.20 / $107.20	Facility	26	$107.20	$107.20	$107.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.85 / $474.28 / $855.82	Professional		$274.85	$474.28	$855.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.23 / $113.86 / $171.63	Professional	26	$69.23	$113.86	$171.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.46 / $332.50 / $708.57	Professional	TC	$188.46	$332.50	$708.57
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $308.08 / $477.73 / $2,250.67	Professional		$308.08	$477.73	$2,250.67
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $98.51 / $140.08 / $797.74	Professional	26	$98.51	$140.08	$797.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $216.48 / $339.58 / $1,583.51	Professional	TC	$216.48	$339.58	$1,583.51
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 $321.89 / $329.02 / $354.89	Professional		$321.89	$329.02	$354.89
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $98.81 / $101.17 / $106.72	Professional	26	$98.81	$101.17	$106.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $220.73 / $230.20 / $248.17	Professional	TC	$220.73	$230.20	$248.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $111.64 / $371.27	Professional		$32.34	$111.64	$371.27
United Facility/Professional Professional Modifier Low / Median / High Price $312.80 / $544.35 / $832.66	Professional		$312.80	$544.35	$832.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.19 / $106.54 / $166.85	Professional	26	$84.19	$106.54	$166.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $224.30 / $379.61 / $672.93	Professional	TC	$224.30	$379.61	$672.93