Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $95.50 / $169.82	Facility	26	$57.54	$95.50	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $234.42 / $512.86	Professional		$102.33	$234.42	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $85.11 / $204.17	Professional	26	$52.48	$85.11	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $208.93 / $416.87	Professional	TC	$144.54	$208.93	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $42.66 / $58.88	Professional	26	$40.74	$42.66	$58.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $199.53 / $446.68	Professional		$69.18	$199.53	$446.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $501.19	Professional		$194.98	$302.00	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $75.86 / $112.20	Professional	26	$46.77	$75.86	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $223.87 / $407.38	Professional	TC	$141.25	$223.87	$407.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $416.87 / $1,412.54	Professional		$229.09	$416.87	$1,412.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $109.65 / $426.58	Professional	26	$64.57	$109.65	$426.58
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $316.23 / $1,047.13	Professional	TC	$169.82	$316.23	$1,047.13
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 $239.88 / $245.47 / $263.03	Professional		$239.88	$245.47	$263.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $67.61 / $70.79	Professional	26	$66.07	$67.61	$70.79
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $177.83 / $190.55	Professional	TC	$169.82	$177.83	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $302.00 / $446.68	Professional		$213.80	$302.00	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $107.15	Professional	26	$52.48	$69.18	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $229.09 / $346.74	Professional	TC	$154.88	$229.09	$346.74