Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.17 / $90.46 / $99.03	Facility	26	$54.17	$90.46	$99.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.67 / $418.27 / $767.55	Professional		$338.67	$418.27	$767.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.89 / $58.59 / $140.08	Professional	26	$50.89	$58.59	$140.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $287.33 / $363.54 / $531.90	Professional	TC	$287.33	$363.54	$531.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $350.00 / $384.51 / $404.96	Professional		$350.00	$384.51	$404.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.99 / $63.18 / $84.24	Professional	26	$56.99	$63.18	$84.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.73 / $201.40 / $689.41	Professional		$61.73	$201.40	$689.41
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 $223.72 / $585.07 / $841.60	Professional		$223.72	$585.07	$841.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.86 / $77.92 / $125.00	Professional	26	$56.86	$77.92	$125.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $170.26 / $512.71 / $737.52	Professional	TC	$170.26	$512.71	$737.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $367.85 / $607.57 / $1,184.08	Professional		$367.85	$607.57	$1,184.08
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.92 / $83.06 / $275.80	Professional	26	$57.92	$83.06	$275.80
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $278.19 / $522.89 / $939.16	Professional	TC	$278.19	$522.89	$939.16
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 $497.31 / $524.64 / $585.07	Professional		$497.31	$524.64	$585.07
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.50 / $67.70 / $72.36	Professional	26	$61.50	$67.70	$72.36
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $435.80 / $456.20 / $512.71	Professional	TC	$435.80	$456.20	$512.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $52.65 / $591.59	Professional		$32.34	$52.65	$591.59
United Facility/Professional Professional Modifier Low / Median / High Price $264.36 / $485.52 / $897.36	Professional		$264.36	$485.52	$897.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.49 / $75.70 / $126.11	Professional	26	$51.49	$75.70	$126.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $214.64 / $420.01 / $752.40	Professional	TC	$214.64	$420.01	$752.40