Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.67 / $126.91 / $192.24	Facility	26	$81.67	$126.91	$192.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.69 / $475.00 / $1,005.17	Professional		$322.69	$475.00	$1,005.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.31 / $137.63 / $389.19	Professional	26	$81.31	$137.63	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $253.09 / $335.00 / $491.35	Professional	TC	$253.09	$335.00	$491.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.13 / $153.13 / $228.80	Professional		$153.13	$153.13	$228.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.11 / $73.26 / $98.25	Professional	26	$57.11	$73.26	$98.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $365.82 / $701.28	Professional		$96.60	$365.82	$701.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.90 / $101.90 / $101.90	Facility	26	$101.90	$101.90	$101.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.74 / $494.11 / $878.77	Professional		$316.74	$494.11	$878.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.13 / $108.07 / $160.77	Professional	26	$65.13	$108.07	$160.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $236.60 / $373.69 / $740.76	Professional	TC	$236.60	$373.69	$740.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $348.41 / $554.29 / $2,438.38	Professional		$348.41	$554.29	$2,438.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.63 / $131.81 / $680.01	Professional	26	$92.63	$131.81	$680.01
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $271.77 / $426.30 / $1,832.89	Professional	TC	$271.77	$426.30	$1,832.89
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 $372.29 / $382.60 / $411.76	Professional		$372.29	$382.60	$411.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.24 / $95.20 / $100.35	Professional	26	$93.24	$95.20	$100.35
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $277.10 / $289.35 / $311.42	Professional	TC	$277.10	$289.35	$311.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $104.98 / $430.77	Professional		$32.34	$104.98	$430.77
United Facility/Professional Professional Modifier Low / Median / High Price $368.84 / $550.04 / $866.74	Professional		$368.84	$550.04	$866.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.81 / $99.84 / $182.02	Professional	26	$78.81	$99.84	$182.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $283.26 / $433.18 / $697.66	Professional	TC	$283.26	$433.18	$697.66