Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.79 / $55.43 / $65.31	Facility	26	$32.79	$55.43	$65.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.87 / $292.12 / $776.52	Professional		$251.87	$292.12	$776.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.17 / $46.39 / $109.89	Professional	26	$33.17	$46.39	$109.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.71 / $256.93 / $484.13	Professional	TC	$218.71	$256.93	$484.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.74 / $49.82 / $50.33	Professional	26	$44.74	$49.82	$50.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.65 / $167.08 / $650.34	Professional		$46.65	$167.08	$650.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.16 / $400.05 / $680.53	Professional		$228.16	$400.05	$680.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.31 / $52.19 / $83.22	Professional	26	$33.31	$52.19	$83.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $189.49 / $349.72 / $599.50	Professional	TC	$189.49	$349.72	$599.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $269.75 / $414.86 / $868.62	Professional		$269.75	$414.86	$868.62
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.02 / $56.55 / $204.03	Professional	26	$39.02	$56.55	$204.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $239.73 / $368.43 / $716.34	Professional	TC	$239.73	$368.43	$716.34
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 $345.24 / $356.41 / $385.23	Professional		$345.24	$356.41	$385.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.64 / $45.90 / $48.46	Professional	26	$44.64	$45.90	$48.46
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $299.35 / $311.77 / $336.77	Professional	TC	$299.35	$311.77	$336.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $50.70 / $403.01	Professional		$32.34	$50.70	$403.01
United Facility/Professional Professional Modifier Low / Median / High Price $249.50 / $377.95 / $687.11	Professional		$249.50	$377.95	$687.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.61 / $48.78 / $79.18	Professional	26	$37.61	$48.78	$79.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $212.71 / $311.86 / $590.76	Professional	TC	$212.71	$311.86	$590.76