Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $112.20 / $269.15	Facility	26	$60.26	$112.20	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $275.42 / $616.60	Professional		$177.83	$275.42	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $69.18 / $151.36	Professional	26	$51.29	$69.18	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $199.53 / $398.11	Professional	TC	$134.90	$199.53	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $53.70 / $60.26	Professional	26	$42.66	$53.70	$60.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $199.53 / $436.52	Professional		$72.44	$199.53	$436.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $75.86 / $75.86	Facility	26	$75.86	$75.86	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $323.59 / $602.56	Professional		$204.17	$323.59	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $81.28 / $120.23	Professional	26	$48.98	$81.28	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $239.88 / $478.63	Professional	TC	$144.54	$239.88	$478.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $489.78 / $1,905.46	Professional		$223.87	$489.78	$1,905.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $114.82 / $588.84	Professional	26	$67.61	$114.82	$588.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $371.54 / $1,412.54	Professional	TC	$162.18	$371.54	$1,412.54
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 $234.42 / $239.88 / $257.04	Professional		$234.42	$239.88	$257.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $70.79 / $74.13	Professional	26	$69.18	$70.79	$74.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $169.82 / $181.97	Professional	TC	$162.18	$169.82	$181.97
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 $223.87 / $354.81 / $537.03	Professional		$223.87	$354.81	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $109.65	Professional	26	$54.95	$72.44	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $275.42 / $457.09	Professional	TC	$162.18	$275.42	$457.09