Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.71 / $51.91 / $61.76	Facility	26	$31.71	$51.91	$61.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.17 / $311.00 / $635.87	Professional		$255.17	$311.00	$635.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.39 / $39.26 / $94.10	Professional	26	$30.39	$39.26	$94.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $221.59 / $275.38 / $492.37	Professional	TC	$221.59	$275.38	$492.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.74 / $36.74 / $36.74	Professional	26	$36.74	$36.74	$36.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.79 / $156.63 / $636.61	Professional		$43.79	$156.63	$636.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.18 / $406.11 / $689.55	Professional		$274.18	$406.11	$689.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.23 / $48.98 / $79.48	Professional	26	$31.23	$48.98	$79.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $248.48 / $361.85 / $610.30	Professional	TC	$248.48	$361.85	$610.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $285.97 / $421.16 / $1,046.04	Professional		$285.97	$421.16	$1,046.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.40 / $52.96 / $189.04	Professional	26	$36.40	$52.96	$189.04
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $249.56 / $357.13 / $761.95	Professional	TC	$249.56	$357.13	$761.95
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 $337.96 / $349.34 / $377.10	Professional		$337.96	$349.34	$377.10
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.73 / $43.03 / $45.49	Professional	26	$41.73	$43.03	$45.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.87 / $294.93 / $331.62	Professional	TC	$281.87	$294.93	$331.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $47.59 / $394.51	Professional		$32.34	$47.59	$394.51
United Facility/Professional Professional Modifier Low / Median / High Price $313.64 / $400.40 / $658.02	Professional		$313.64	$400.40	$658.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.47 / $46.47 / $73.20	Professional	26	$36.47	$46.47	$73.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $282.06 / $361.43 / $576.42	Professional	TC	$282.06	$361.43	$576.42