Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $138.04 / $257.04	Facility	26	$75.86	$138.04	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $645.65 / $2,187.76	Professional		$407.38	$645.65	$2,187.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $128.82 / $380.19	Professional	26	$75.86	$128.82	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $467.74 / $891.25	Professional	TC	$309.03	$467.74	$891.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $446.68 / $645.65	Professional		$346.74	$446.68	$645.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $83.18 / $120.23	Professional	26	$60.26	$83.18	$120.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $371.54 / $977.24	Professional		$104.71	$371.54	$977.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $588.84 / $933.25	Professional		$398.11	$588.84	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $109.65 / $158.49	Professional	26	$75.86	$109.65	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $501.19 / $812.83	Professional	TC	$323.59	$501.19	$812.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $660.69 / $2,137.96	Professional		$398.11	$660.69	$2,137.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $131.83 / $1,000.00	Professional	26	$87.10	$131.83	$1,000.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $537.03 / $1,584.89	Professional	TC	$346.74	$537.03	$1,584.89
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 $512.86 / $537.03 / $575.44	Professional		$512.86	$537.03	$575.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $102.33 / $107.15	Professional	26	$100.00	$102.33	$107.15
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $426.58 / $467.74	Professional	TC	$416.87	$426.58	$467.74
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 $446.68 / $602.56 / $912.01	Professional		$446.68	$602.56	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $102.33 / $151.36	Professional	26	$79.43	$102.33	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $512.86 / $758.58	Professional	TC	$380.19	$512.86	$758.58