Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.32 / $95.84 / $107.97	Facility	26	$58.32	$95.84	$107.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.84 / $272.22 / $434.90	Professional		$183.84	$272.22	$434.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $60.22 / $114.40	Professional	26	$50.07	$60.22	$114.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.05 / $222.12 / $324.20	Professional	TC	$147.05	$222.12	$324.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $261.35 / $261.35 / $261.35	Professional		$261.35	$261.35	$261.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.21 / $51.80 / $72.20	Professional	26	$40.21	$51.80	$72.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.76 / $234.69 / $449.90	Professional		$68.76	$234.69	$449.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.00 / $72.00 / $72.00	Facility	26	$72.00	$72.00	$72.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.49 / $305.94 / $478.21	Professional		$198.49	$305.94	$478.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.39 / $75.00 / $113.31	Professional	26	$46.39	$75.00	$113.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $143.29 / $225.61 / $359.13	Professional	TC	$143.29	$225.61	$359.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $229.08 / $349.07 / $1,156.61	Professional		$229.08	$349.07	$1,156.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.94 / $93.87 / $382.05	Professional	26	$65.94	$93.87	$382.05
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $167.76 / $263.16 / $870.94	Professional	TC	$167.76	$263.16	$870.94
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 $238.84 / $244.93 / $263.69	Professional		$238.84	$244.93	$263.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.38 / $67.80 / $71.44	Professional	26	$66.38	$67.80	$71.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $171.05 / $178.56 / $192.27	Professional	TC	$171.05	$178.56	$192.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $74.73 / $275.86	Professional		$32.34	$74.73	$275.86
United Facility/Professional Professional Modifier Low / Median / High Price $223.57 / $309.14 / $458.58	Professional		$223.57	$309.14	$458.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $74.15 / $132.22	Professional	26	$56.23	$74.15	$132.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $164.39 / $237.85 / $355.94	Professional	TC	$164.39	$237.85	$355.94