Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $389.05 / $691.83 / $1,318.26	Facility	26	$389.05	$691.83	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,344.23 / $8,317.64	Professional		$1,621.81	$2,344.23	$8,317.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $371.54 / $645.65 / $1,737.80	Professional	26	$371.54	$645.65	$1,737.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,174.90 / $1,737.80 / $3,388.44	Professional	TC	$1,174.90	$1,737.80	$3,388.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,862.09 / $2,754.23	Professional		$1,479.11	$1,862.09	$2,754.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $316.23 / $426.58 / $588.84	Professional	26	$316.23	$426.58	$588.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $1,905.46 / $4,073.80	Professional		$537.03	$1,905.46	$4,073.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,511.89 / $3,715.35	Professional		$1,659.59	$2,511.89	$3,715.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $549.54 / $812.83	Professional	26	$380.19	$549.54	$812.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,288.25 / $1,949.84 / $3,019.95	Professional	TC	$1,288.25	$1,949.84	$3,019.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,951.21 / $7,943.28	Professional		$1,819.70	$2,951.21	$7,943.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $446.68 / $676.08 / $2,691.53	Professional	26	$446.68	$676.08	$2,691.53
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,412.54 / $2,238.72 / $5,128.61	Professional	TC	$1,412.54	$2,238.72	$5,128.61
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 $2,187.76 / $2,238.72 / $2,398.83	Professional		$2,187.76	$2,238.72	$2,398.83
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $512.86 / $524.81 / $549.54	Professional	26	$512.86	$524.81	$549.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,659.59 / $1,698.24 / $1,862.09	Professional	TC	$1,659.59	$1,698.24	$1,862.09
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 $1,905.46 / $2,511.89 / $3,467.37	Professional		$1,905.46	$2,511.89	$3,467.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $407.38 / $524.81 / $758.58	Professional	26	$407.38	$524.81	$758.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,513.56 / $1,949.84 / $2,754.23	Professional	TC	$1,513.56	$1,949.84	$2,754.23