Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.09 / $91.56 / $99.15	Facility	26	$53.09	$91.56	$99.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.31 / $330.02 / $586.60	Professional		$273.31	$330.02	$586.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.03 / $53.09 / $99.24	Professional	26	$49.03	$53.09	$99.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.79 / $280.99 / $488.08	Professional	TC	$223.79	$280.99	$488.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.47 / $74.47 / $74.47	Professional	26	$74.47	$74.47	$74.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.56 / $250.11 / $692.20	Professional		$69.56	$250.11	$692.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.18 / $439.58 / $747.39	Professional		$302.18	$439.58	$747.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.86 / $77.81 / $125.51	Professional	26	$49.86	$77.81	$125.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.05 / $366.59 / $620.19	Professional	TC	$253.05	$366.59	$620.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $310.94 / $457.93 / $1,456.32	Professional		$310.94	$457.93	$1,456.32
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.14 / $79.28 / $174.77	Professional	26	$58.14	$79.28	$174.77
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $252.80 / $361.76 / $812.41	Professional	TC	$252.80	$361.76	$812.41
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 $367.47 / $378.89 / $408.19	Professional		$367.47	$378.89	$408.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.43 / $67.25 / $72.27	Professional	26	$61.43	$67.25	$72.27
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $285.52 / $298.77 / $335.92	Professional	TC	$285.52	$298.77	$335.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $75.59 / $427.03	Professional		$32.34	$75.59	$427.03
United Facility/Professional Professional Modifier Low / Median / High Price $345.97 / $457.52 / $682.85	Professional		$345.97	$457.52	$682.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.75 / $74.86 / $119.76	Professional	26	$58.75	$74.86	$119.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $291.87 / $370.98 / $593.54	Professional	TC	$291.87	$370.98	$593.54