Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.72 / $92.38 / $134.90	Facility	26	$58.72	$92.38	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $382.41 / $451.62 / $749.38	Professional		$382.41	$451.62	$749.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.34 / $64.48 / $119.17	Professional	26	$54.34	$64.48	$119.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $326.64 / $384.84 / $657.32	Professional	TC	$326.64	$384.84	$657.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.06 / $69.06 / $69.06	Professional	26	$69.06	$69.06	$69.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.39 / $305.72 / $674.51	Professional		$62.39	$305.72	$674.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.81 / $64.81 / $64.81	Facility	26	$64.81	$64.81	$64.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $433.48 / $658.14 / $971.85	Professional		$433.48	$658.14	$971.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.07 / $88.01 / $137.63	Professional	26	$59.07	$88.01	$137.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $374.06 / $575.64 / $850.82	Professional	TC	$374.06	$575.64	$850.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $413.92 / $622.85 / $1,910.94	Professional		$413.92	$622.85	$1,910.94
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.94 / $90.01 / $352.36	Professional	26	$58.94	$90.01	$352.36
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $357.66 / $545.01 / $1,541.19	Professional	TC	$357.66	$545.01	$1,541.19
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 $486.55 / $512.47 / $572.41	Professional		$486.55	$512.47	$572.41
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $68.72 / $73.14	Professional	26	$62.17	$68.72	$73.14
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $424.39 / $442.82 / $499.28	Professional	TC	$424.39	$442.82	$499.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $75.01 / $576.09	Professional		$32.34	$75.01	$576.09
United Facility/Professional Professional Modifier Low / Median / High Price $388.18 / $595.47 / $1,000.00	Professional		$388.18	$595.47	$1,000.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.36 / $90.95 / $149.80	Professional	26	$56.36	$90.95	$149.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $327.82 / $498.72 / $834.52	Professional	TC	$327.82	$498.72	$834.52