Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.09 / $74.13 / $89.13	Facility	26	$45.09	$74.13	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.43 / $306.20 / $573.77	Professional		$258.43	$306.20	$573.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.47 / $49.38 / $109.95	Professional	26	$43.47	$49.38	$109.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $214.71 / $254.90 / $481.29	Professional	TC	$214.71	$254.90	$481.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.85 / $51.85 / $66.23	Professional	26	$51.85	$51.85	$66.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.79 / $222.51 / $652.64	Professional		$61.79	$222.51	$652.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $268.92 / $414.67 / $699.98	Professional		$268.92	$414.67	$699.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.36 / $69.13 / $113.55	Professional	26	$44.36	$69.13	$113.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $230.33 / $345.55 / $584.91	Professional	TC	$230.33	$345.55	$584.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $293.16 / $429.49 / $1,576.45	Professional		$293.16	$429.49	$1,576.45
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.72 / $75.55 / $303.88	Professional	26	$51.72	$75.55	$303.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $246.82 / $357.89 / $1,237.29	Professional	TC	$246.82	$357.89	$1,237.29
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 $346.46 / $357.58 / $385.06	Professional		$346.46	$357.58	$385.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.03 / $61.13 / $64.19	Professional	26	$60.03	$61.13	$64.19
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $285.35 / $297.54 / $320.87	Professional	TC	$285.35	$297.54	$320.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $67.16 / $402.83	Professional		$32.34	$67.16	$402.83
United Facility/Professional Professional Modifier Low / Median / High Price $312.02 / $435.19 / $666.71	Professional		$312.02	$435.19	$666.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.53 / $66.23 / $131.38	Professional	26	$50.53	$66.23	$131.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $262.74 / $349.61 / $581.34	Professional	TC	$262.74	$349.61	$581.34