Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $177.83 / $316.23	Facility	26	$107.15	$177.83	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $524.81 / $2,089.30	Professional		$218.78	$524.81	$2,089.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $181.97 / $512.86	Professional	26	$102.33	$181.97	$512.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $436.52 / $1,000.00	Professional	TC	$288.40	$436.52	$1,000.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $371.54	Professional		$354.81	$354.81	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $95.50 / $141.25	Professional	26	$75.86	$95.50	$141.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $407.38 / $870.96	Professional		$128.82	$407.38	$870.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $645.65 / $1,318.26	Professional		$416.87	$645.65	$1,318.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $144.54 / $213.80	Professional	26	$87.10	$144.54	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $489.78 / $1,122.02	Professional	TC	$316.23	$489.78	$1,122.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $1,122.02 / $3,715.35	Professional		$446.68	$1,122.02	$3,715.35
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $199.53 / $977.24	Professional	26	$120.23	$199.53	$977.24
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $912.01 / $2,951.21	Professional	TC	$354.81	$912.01	$2,951.21
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 $489.78 / $501.19 / $537.03	Professional		$489.78	$501.19	$537.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $125.89 / $134.90	Professional	26	$123.03	$125.89	$134.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $380.19 / $407.38	Professional	TC	$363.08	$380.19	$407.38
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 $457.09 / $724.44 / $1,318.26	Professional		$457.09	$724.44	$1,318.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $125.89 / $199.53	Professional	26	$97.72	$125.89	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $562.34 / $1,096.48	Professional	TC	$354.81	$562.34	$1,096.48