Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.43 / $317.68 / $638.57	Facility	26	$208.43	$317.68	$638.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.23 / $557.72 / $1,550.46	Professional		$407.23	$557.72	$1,550.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $198.28 / $292.75 / $760.27	Professional	26	$198.28	$292.75	$760.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $209.55 / $347.18 / $693.98	Professional	TC	$209.55	$347.18	$693.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $376.17 / $488.29 / $508.94	Professional		$376.17	$488.29	$508.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $164.59 / $240.03 / $274.32	Professional	26	$164.59	$240.03	$274.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $286.08 / $570.05 / $1,092.79	Professional		$286.08	$570.05	$1,092.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $490.43 / $732.44 / $1,517.26	Professional		$490.43	$732.44	$1,517.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $217.81 / $308.61 / $484.38	Professional	26	$217.81	$308.61	$484.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.63 / $392.96 / $1,198.43	Professional	TC	$253.63	$392.96	$1,198.43
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $490.89 / $825.58 / $4,354.43	Professional		$490.89	$825.58	$4,354.43
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $245.33 / $365.76 / $2,273.08	Professional	26	$245.33	$365.76	$2,273.08
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $272.69 / $439.24 / $2,886.97	Professional	TC	$272.69	$439.24	$2,886.97
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 $580.14 / $588.58 / $634.78	Professional		$580.14	$588.58	$634.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $277.33 / $280.39 / $297.18	Professional	26	$277.33	$280.39	$297.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $299.74 / $311.25 / $337.61	Professional	TC	$299.74	$311.25	$337.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $301.97 / $664.07	Professional		$32.34	$301.97	$664.07
United Facility/Professional Professional Modifier Low / Median / High Price $498.04 / $697.26 / $1,334.44	Professional		$498.04	$697.26	$1,334.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $229.42 / $294.07 / $462.72	Professional	26	$229.42	$294.07	$462.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.39 / $389.68 / $779.32	Professional	TC	$269.39	$389.68	$779.32