Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $64.57 / $263.03	Facility	26	$50.12	$64.57	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $223.87 / $724.44	Professional		$177.83	$223.87	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $52.48 / $131.83	Professional	26	$42.66	$52.48	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $162.18 / $309.03	Professional	TC	$128.82	$162.18	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $48.98 / $70.79	Professional	26	$38.90	$48.98	$70.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $208.93 / $446.68	Professional		$66.07	$208.93	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $524.81	Professional		$194.98	$302.00	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $72.44 / $107.15	Professional	26	$43.65	$72.44	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $331.13	Professional	TC	$144.54	$218.78	$331.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $457.09 / $1,737.80	Professional		$223.87	$457.09	$1,737.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $79.43 / $407.38	Professional	26	$56.23	$79.43	$407.38
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $223.87 / $1,071.52	Professional	TC	$162.18	$223.87	$1,071.52
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 $57.54 / $63.10 / $67.61	Professional	26	$57.54	$63.10	$67.61
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $173.78 / $194.98	Professional	TC	$165.96	$173.78	$194.98
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 $208.93 / $275.42 / $416.87	Professional		$208.93	$275.42	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $67.61 / $104.71	Professional	26	$51.29	$67.61	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $208.93 / $316.23	Professional	TC	$158.49	$208.93	$316.23