Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.21 / $56.05 / $75.42	Facility	26	$37.21	$56.05	$75.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.91 / $418.31 / $734.85	Professional		$338.91	$418.31	$734.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.71 / $47.96 / $113.53	Professional	26	$36.71	$47.96	$113.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $301.69 / $375.12 / $657.78	Professional	TC	$301.69	$375.12	$657.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.12 / $32.27 / $50.62	Professional	26	$30.12	$32.27	$50.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.79 / $383.50 / $853.75	Professional		$52.79	$383.50	$853.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $375.30 / $549.15 / $934.41	Professional		$375.30	$549.15	$934.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.78 / $59.06 / $95.87	Professional	26	$37.78	$59.06	$95.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $339.74 / $493.73 / $837.65	Professional	TC	$339.74	$493.73	$837.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $378.83 / $560.52 / $1,161.06	Professional		$378.83	$560.52	$1,161.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.04 / $64.06 / $230.69	Professional	26	$44.04	$64.06	$230.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $347.06 / $499.94 / $1,011.27	Professional	TC	$347.06	$499.94	$1,011.27
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 $453.23 / $469.03 / $506.03	Professional		$453.23	$469.03	$506.03
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.88 / $52.05 / $54.83	Professional	26	$50.88	$52.05	$54.83
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $401.18 / $418.15 / $451.18	Professional	TC	$401.18	$418.15	$451.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $57.36 / $529.38	Professional		$32.34	$57.36	$529.38
United Facility/Professional Professional Modifier Low / Median / High Price $426.68 / $573.02 / $876.31	Professional		$426.68	$573.02	$876.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.63 / $56.93 / $91.97	Professional	26	$42.63	$56.93	$91.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $390.45 / $536.65 / $784.34	Professional	TC	$390.45	$536.65	$784.34