Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.48 / $603.65 / $1,156.40	Facility		$53.48	$603.65	$1,156.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.98 / $45.39 / $54.88	Facility	26	$26.98	$45.39	$54.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.76 / $103.11 / $559.29	Professional		$50.76	$103.11	$559.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.28 / $42.39 / $161.00	Professional	26	$27.28	$42.39	$161.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.22 / $40.46 / $187.42	Professional	TC	$23.22	$40.46	$187.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $49.10 / $89.66	Professional		$36.54	$49.10	$89.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.28 / $31.92 / $41.04	Professional	26	$22.28	$31.92	$41.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $170.69 / $420.21 / $826.91	Facility		$170.69	$420.21	$826.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $70.80 / $134.02	Professional		$38.04	$70.80	$134.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $296.87 / $296.87 / $296.87	Facility		$296.87	$296.87	$296.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.23 / $91.05 / $241.79	Professional		$52.23	$91.05	$241.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.08 / $42.56 / $64.04	Professional	26	$27.08	$42.56	$64.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.05 / $43.67 / $196.75	Professional	TC	$24.05	$43.67	$196.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $65.68 / $104.14 / $513.69	Professional		$65.68	$104.14	$513.69
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.59 / $49.27 / $223.22	Professional	26	$33.59	$49.27	$223.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.02 / $47.77 / $395.36	Professional	TC	$32.02	$47.77	$395.36
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
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 $71.15 / $71.38 / $77.36	Professional		$71.15	$71.38	$77.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.63 / $37.58 / $39.52	Professional	26	$36.63	$37.58	$39.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.57 / $34.75 / $37.84	Professional	TC	$33.57	$34.75	$37.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $36.15 / $80.93	Professional		$32.34	$36.15	$80.93
United Facility/Professional Professional Modifier Low / Median / High Price $58.20 / $87.79 / $229.33	Professional		$58.20	$87.79	$229.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $39.04 / $60.33	Professional	26	$30.50	$39.04	$60.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.40 / $40.25 / $186.38	Professional	TC	$25.40	$40.25	$186.38