Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.23 / $116.14 / $233.22	Facility	26	$76.23	$116.14	$233.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $409.29 / $583.44 / $1,357.98	Professional		$409.29	$583.44	$1,357.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.30 / $109.27 / $291.31	Professional	26	$69.30	$109.27	$291.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $305.26 / $468.45 / $801.12	Professional	TC	$305.26	$468.45	$801.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $337.39 / $439.55 / $459.62	Professional		$337.39	$439.55	$459.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.90 / $82.99 / $99.83	Professional	26	$59.90	$82.99	$99.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.11 / $371.55 / $969.22	Professional		$104.11	$371.55	$969.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $382.46 / $593.39 / $986.90	Professional		$382.46	$593.39	$986.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.42 / $112.30 / $177.34	Professional	26	$75.42	$112.30	$177.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $312.74 / $491.80 / $809.56	Professional	TC	$312.74	$491.80	$809.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $430.06 / $659.33 / $2,052.73	Professional		$430.06	$659.33	$2,052.73
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.51 / $133.10 / $616.37	Professional	26	$91.51	$133.10	$616.37
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $349.02 / $534.54 / $1,577.76	Professional	TC	$349.02	$534.54	$1,577.76
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 $514.54 / $532.45 / $571.41	Professional		$514.54	$532.45	$571.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.04 / $102.06 / $108.15	Professional	26	$101.04	$102.06	$108.15
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $412.48 / $431.42 / $463.27	Professional	TC	$412.48	$431.42	$463.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $122.29 / $597.79	Professional		$32.34	$122.29	$597.79
United Facility/Professional Professional Modifier Low / Median / High Price $449.66 / $630.28 / $1,013.13	Professional		$449.66	$630.28	$1,013.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.17 / $106.05 / $169.88	Professional	26	$79.17	$106.05	$169.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $402.05 / $516.65 / $788.79	Professional	TC	$402.05	$516.65	$788.79