Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.96 / $120.34 / $288.36	Facility	26	$85.96	$120.34	$288.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $704.85 / $827.08 / $1,475.10	Professional		$704.85	$827.08	$1,475.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.96 / $94.97 / $192.26	Professional	26	$85.96	$94.97	$192.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $618.89 / $727.23 / $1,329.36	Professional	TC	$618.89	$727.23	$1,329.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $115.34 / $115.34 / $115.34	Professional	26	$115.34	$115.34	$115.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.28 / $433.58 / $1,758.12	Professional		$120.28	$433.58	$1,758.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $760.38 / $1,120.71 / $1,885.97	Professional		$760.38	$1,120.71	$1,885.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.50 / $129.88 / $219.21	Professional	26	$83.50	$129.88	$219.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $679.75 / $997.02 / $1,665.18	Professional	TC	$679.75	$997.02	$1,665.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $789.75 / $1,163.08 / $5,180.30	Professional		$789.75	$1,163.08	$5,180.30
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.78 / $137.43 / $330.86	Professional	26	$100.78	$137.43	$330.86
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $688.97 / $986.15 / $2,924.15	Professional	TC	$688.97	$986.15	$2,924.15
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 $933.34 / $965.59 / $1,040.65	Professional		$933.34	$965.59	$1,040.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $106.21 / $116.82 / $124.96	Professional	26	$106.21	$116.82	$124.96
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $778.35 / $814.24 / $915.71	Professional	TC	$778.35	$814.24	$915.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $130.72 / $1,088.68	Professional		$32.34	$130.72	$1,088.68
United Facility/Professional Professional Modifier Low / Median / High Price $879.90 / $1,188.90 / $1,822.33	Professional		$879.90	$1,188.90	$1,822.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.48 / $123.84 / $203.40	Professional	26	$102.48	$123.84	$203.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $770.28 / $1,031.82 / $1,561.07	Professional	TC	$770.28	$1,031.82	$1,561.07