Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.51 / $104.91 / $138.63	Facility	26	$76.51	$104.91	$138.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.85 / $428.51 / $791.47	Professional		$342.85	$428.51	$791.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.56 / $77.67 / $171.32	Professional	26	$68.56	$77.67	$171.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $274.27 / $331.88 / $576.98	Professional	TC	$274.27	$331.88	$576.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $98.43 / $98.43 / $98.43	Professional	26	$98.43	$98.43	$98.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.24 / $328.81 / $858.27	Professional		$91.24	$328.81	$858.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $332.91 / $544.42 / $906.90	Professional		$332.91	$544.42	$906.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.98 / $102.07 / $166.77	Professional	26	$65.98	$102.07	$166.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $266.22 / $442.36 / $746.91	Professional	TC	$266.22	$442.36	$746.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $379.31 / $563.88 / $2,112.41	Professional		$379.31	$563.88	$2,112.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.43 / $104.22 / $229.23	Professional	26	$76.43	$104.22	$229.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $309.11 / $442.36 / $993.41	Professional	TC	$309.11	$442.36	$993.41
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 $455.64 / $469.63 / $505.54	Professional		$455.64	$469.63	$505.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.56 / $88.63 / $94.78	Professional	26	$80.56	$88.63	$94.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $349.15 / $365.31 / $410.76	Professional	TC	$349.15	$365.31	$410.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $99.16 / $528.88	Professional		$32.34	$99.16	$528.88
United Facility/Professional Professional Modifier Low / Median / High Price $388.32 / $506.55 / $855.56	Professional		$388.32	$506.55	$855.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.78 / $98.56 / $155.04	Professional	26	$77.78	$98.56	$155.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $307.64 / $446.06 / $713.30	Professional	TC	$307.64	$446.06	$713.30