Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.19 / $150.83 / $200.47	Facility	26	$90.19	$150.83	$200.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $358.17 / $475.00 / $745.43	Professional		$358.17	$475.00	$745.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.29 / $130.11 / $189.00	Professional	26	$89.29	$130.11	$189.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $262.50 / $335.00 / $512.91	Professional	TC	$262.50	$335.00	$512.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.72 / $64.16 / $108.85	Professional	26	$61.72	$64.16	$108.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.22 / $383.24 / $758.20	Professional		$107.22	$383.24	$758.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.84 / $110.84 / $110.84	Facility	26	$110.84	$110.84	$110.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $343.68 / $529.85 / $852.60	Professional		$343.68	$529.85	$852.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.47 / $118.63 / $179.32	Professional	26	$71.47	$118.63	$179.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.79 / $394.77 / $685.24	Professional	TC	$253.79	$394.77	$685.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $377.03 / $599.80 / $2,334.09	Professional		$377.03	$599.80	$2,334.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.04 / $145.76 / $651.16	Professional	26	$102.04	$145.76	$651.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $291.52 / $457.28 / $1,800.33	Professional	TC	$291.52	$457.28	$1,800.33
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 $402.51 / $412.05 / $445.58	Professional		$402.51	$412.05	$445.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.04 / $105.27 / $111.37	Professional	26	$102.04	$105.27	$111.37
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $297.23 / $310.02 / $334.20	Professional	TC	$297.23	$310.02	$334.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $116.51 / $466.14	Professional		$32.34	$116.51	$466.14
United Facility/Professional Professional Modifier Low / Median / High Price $390.32 / $537.85 / $832.00	Professional		$390.32	$537.85	$832.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.74 / $112.34 / $171.42	Professional	26	$86.74	$112.34	$171.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $299.39 / $441.21 / $721.55	Professional	TC	$299.39	$441.21	$721.55