Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $388.58 / $592.20 / $1,190.14	Facility	26	$388.58	$592.20	$1,190.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,542.03 / $2,115.42 / $5,878.67	Professional		$1,542.03	$2,115.42	$5,878.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $347.37 / $513.14 / $1,366.19	Professional	26	$347.37	$513.14	$1,366.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,171.07 / $1,745.82 / $2,807.44	Professional	TC	$1,171.07	$1,745.82	$2,807.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,417.67 / $1,857.56 / $1,932.25	Professional		$1,417.67	$1,857.56	$1,932.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $307.72 / $448.76 / $576.98	Professional	26	$307.72	$448.76	$576.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $534.85 / $1,906.46 / $4,096.77	Professional		$534.85	$1,906.46	$4,096.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,649.94 / $2,507.71 / $3,921.57	Professional		$1,649.94	$2,507.71	$3,921.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $384.56 / $571.44 / $900.50	Professional	26	$384.56	$571.44	$900.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,258.34 / $1,930.74 / $3,021.07	Professional	TC	$1,258.34	$1,930.74	$3,021.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,840.27 / $2,819.03 / $7,300.12	Professional		$1,840.27	$2,819.03	$7,300.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $448.76 / $678.38 / $2,146.10	Professional	26	$448.76	$678.38	$2,146.10
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,397.14 / $2,188.16 / $5,154.02	Professional	TC	$1,397.14	$2,188.16	$5,154.02
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 $2,174.86 / $2,232.69 / $2,414.83	Professional		$2,174.86	$2,232.69	$2,414.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $516.97 / $523.71 / $555.61	Professional	26	$516.97	$523.71	$555.61
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,651.17 / $1,715.71 / $1,859.22	Professional	TC	$1,651.17	$1,715.71	$1,859.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $628.26 / $2,526.28	Professional		$32.34	$628.26	$2,526.28
United Facility/Professional Professional Modifier Low / Median / High Price $1,932.23 / $2,522.69 / $3,897.17	Professional		$1,932.23	$2,522.69	$3,897.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $410.64 / $526.47 / $1,072.84	Professional	26	$410.64	$526.47	$1,072.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,516.49 / $1,980.38 / $2,788.39	Professional	TC	$1,516.49	$1,980.38	$2,788.39