Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $316.23 / $457.09 / $549.54	Facility	26	$316.23	$457.09	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,230.27 / $2,290.87	Professional		$977.24	$1,230.27	$2,290.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $288.40 / $512.86 / $1,318.26	Professional	26	$288.40	$512.86	$1,318.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $724.44 / $870.96 / $1,819.70	Professional	TC	$724.44	$870.96	$1,819.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $257.04 / $338.84 / $436.52	Professional	26	$257.04	$338.84	$436.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $1,000.00 / $1,995.26	Professional		$346.74	$1,000.00	$1,995.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,513.56 / $2,137.96	Professional		$1,096.48	$1,513.56	$2,137.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $316.23 / $457.09 / $630.96	Professional	26	$316.23	$457.09	$630.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $1,047.13 / $1,445.44	Professional	TC	$758.58	$1,047.13	$1,445.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,445.44 / $5,128.61	Professional		$912.01	$1,445.44	$5,128.61
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $316.23 / $446.68 / $1,862.09	Professional	26	$316.23	$446.68	$1,862.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $954.99 / $1,778.28	Professional	TC	$691.83	$954.99	$1,778.28
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 $1,174.90 / $1,174.90 / $1,318.26	Professional		$1,174.90	$1,174.90	$1,318.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $331.13 / $371.54 / $407.38	Professional	26	$331.13	$371.54	$407.38
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $776.25 / $812.83 / $912.01	Professional	TC	$776.25	$812.83	$912.01
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 $1,096.48 / $1,513.56 / $2,187.76	Professional		$1,096.48	$1,513.56	$2,187.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $309.03 / $467.74 / $691.83	Professional	26	$309.03	$467.74	$691.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $1,071.52 / $1,584.89	Professional	TC	$758.58	$1,071.52	$1,584.89