Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $100.00 / $165.96	Facility	26	$52.48	$100.00	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $331.13 / $645.65	Professional		$275.42	$331.13	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $57.54 / $131.83	Professional	26	$45.71	$57.54	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $281.84 / $537.03	Professional	TC	$223.87	$281.84	$537.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $56.23 / $75.86	Professional	26	$52.48	$56.23	$75.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $251.19 / $691.83	Professional		$69.18	$251.19	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $436.52 / $741.31	Professional		$281.84	$436.52	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $77.62 / $125.89	Professional	26	$50.12	$77.62	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $371.54 / $645.65	Professional	TC	$251.19	$371.54	$645.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $467.74 / $1,513.56	Professional		$309.03	$467.74	$1,513.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $79.43 / $229.09	Professional	26	$54.95	$79.43	$229.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $363.08 / $870.96	Professional	TC	$251.19	$363.08	$870.96
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 $371.54 / $380.19 / $407.38	Professional		$371.54	$380.19	$407.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $67.61 / $72.44	Professional	26	$61.66	$67.61	$72.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $302.00 / $338.84	Professional	TC	$288.40	$302.00	$338.84
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 $338.84 / $457.09 / $676.08	Professional		$338.84	$457.09	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $74.13 / $112.20	Professional	26	$56.23	$74.13	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $389.05 / $562.34	Professional	TC	$288.40	$389.05	$562.34