Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $87.10 / $147.91	Facility	26	$45.71	$87.10	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $363.08 / $812.83	Professional		$295.12	$363.08	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $67.61 / $169.82	Professional	26	$43.65	$67.61	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $309.03 / $575.44	Professional	TC	$251.19	$309.03	$575.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $52.48 / $100.00	Professional	26	$37.15	$52.48	$100.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $223.87 / $741.31	Professional		$61.66	$223.87	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $457.09 / $707.95	Professional		$288.40	$457.09	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $69.18 / $112.20	Professional	26	$44.67	$69.18	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $407.38 / $630.96	Professional	TC	$251.19	$407.38	$630.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $489.78 / $2,951.21	Professional		$331.13	$489.78	$2,951.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $79.43 / $457.09	Professional	26	$52.48	$79.43	$457.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $416.87 / $2,454.71	Professional	TC	$288.40	$416.87	$2,454.71
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 $398.11 / $407.38 / $436.52	Professional		$398.11	$407.38	$436.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $61.66 / $64.57	Professional	26	$60.26	$61.66	$64.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $346.74 / $371.54	Professional	TC	$331.13	$346.74	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $446.68 / $707.95	Professional		$323.59	$446.68	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $67.61 / $100.00	Professional	26	$51.29	$67.61	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $380.19 / $630.96	Professional	TC	$269.15	$380.19	$630.96