Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.95 / $90.46 / $99.03	Facility	26	$56.95	$90.46	$99.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $296.76 / $368.26 / $652.07	Professional		$296.76	$368.26	$652.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.89 / $58.15 / $119.67	Professional	26	$50.89	$58.15	$119.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.27 / $305.05 / $445.59	Professional	TC	$251.27	$305.05	$445.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $330.33 / $348.14 / $531.62	Professional		$330.33	$348.14	$531.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.61 / $67.17 / $75.14	Professional	26	$51.61	$67.17	$75.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.73 / $201.40 / $592.10	Professional		$61.73	$201.40	$592.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.56 / $502.49 / $729.43	Professional		$205.56	$502.49	$729.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.86 / $77.92 / $124.30	Professional	26	$56.86	$77.92	$124.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.50 / $430.13 / $618.72	Professional	TC	$167.50	$430.13	$618.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $332.65 / $521.82 / $927.67	Professional		$332.65	$521.82	$927.67
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.29 / $81.61 / $241.44	Professional	26	$57.29	$81.61	$241.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $264.99 / $430.13 / $736.08	Professional	TC	$264.99	$430.13	$736.08
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 $451.20 / $467.47 / $502.49	Professional		$451.20	$467.47	$502.49
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.70 / $68.45 / $72.36	Professional	26	$67.70	$68.45	$72.36
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $382.76 / $399.76 / $430.13	Professional	TC	$382.76	$399.76	$430.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $52.65 / $496.31	Professional		$32.34	$52.65	$496.31
United Facility/Professional Professional Modifier Low / Median / High Price $258.66 / $419.48 / $748.87	Professional		$258.66	$419.48	$748.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.09 / $75.70 / $126.11	Professional	26	$53.09	$75.70	$126.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $205.72 / $364.72 / $621.76	Professional	TC	$205.72	$364.72	$621.76