Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $100.00 / $234.42	Facility	26	$69.18	$100.00	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $338.84 / $1,412.54	Professional		$194.98	$338.84	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $109.65 / $245.47	Professional	26	$64.57	$109.65	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $173.78 / $363.08	Professional	TC	$123.03	$173.78	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $239.88	Professional		$158.49	$158.49	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	26	$79.43	$79.43	$79.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $257.04 / $489.78	Professional		$95.50	$257.04	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $331.13 / $512.86	Professional		$208.93	$331.13	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $104.71 / $154.88	Professional	26	$63.10	$104.71	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $213.80 / $323.59	Professional	TC	$138.04	$213.80	$323.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $501.19 / $1,862.09	Professional		$245.47	$501.19	$1,862.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $114.82 / $588.84	Professional	26	$81.28	$114.82	$588.84
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $218.78 / $1,023.29	Professional	TC	$154.88	$218.78	$1,023.29
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 $263.03 / $269.15 / $288.40	Professional		$263.03	$269.15	$288.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $91.20 / $97.72	Professional	26	$83.18	$91.20	$97.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $169.82 / $190.55	Professional	TC	$162.18	$169.82	$190.55
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 $245.47 / $478.63 / $1,202.26	Professional		$245.47	$478.63	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $95.50 / $147.91	Professional	26	$70.79	$95.50	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $316.23 / $1,071.52	Professional	TC	$165.96	$316.23	$1,071.52