Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.64 / $83.49 / $156.06	Facility	26	$59.64	$83.49	$156.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $373.59 / $463.49 / $931.71	Professional		$373.59	$463.49	$931.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.64 / $69.43 / $177.41	Professional	26	$59.64	$69.43	$177.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $313.95 / $399.20 / $676.14	Professional	TC	$313.95	$399.20	$676.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.03 / $80.03 / $80.03	Professional	26	$80.03	$80.03	$80.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.46 / $301.48 / $935.15	Professional		$83.46	$301.48	$935.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $594.09 / $1,004.86	Professional		$380.19	$594.09	$1,004.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.24 / $91.27 / $154.25	Professional	26	$58.24	$91.27	$154.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $346.81 / $508.77 / $849.64	Professional	TC	$346.81	$508.77	$849.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $420.07 / $618.65 / $2,740.77	Professional		$420.07	$618.65	$2,740.77
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.06 / $95.55 / $223.44	Professional	26	$70.06	$95.55	$223.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $350.00 / $500.72 / $1,390.64	Professional	TC	$350.00	$500.72	$1,390.64
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 $496.44 / $513.15 / $551.66	Professional		$496.44	$513.15	$551.66
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $73.69 / $81.45 / $86.70	Professional	26	$73.69	$81.45	$86.70
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $395.21 / $413.63 / $464.96	Professional	TC	$395.21	$413.63	$464.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $90.70 / $577.12	Professional		$32.34	$90.70	$577.12
United Facility/Professional Professional Modifier Low / Median / High Price $469.08 / $635.26 / $1,014.33	Professional		$469.08	$635.26	$1,014.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.18 / $87.07 / $147.04	Professional	26	$68.18	$87.07	$147.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $387.92 / $543.16 / $842.79	Professional	TC	$387.92	$543.16	$842.79