Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.97 / $200.55 / $209.49	Facility	26	$105.97	$200.55	$209.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $350.44 / $378.49 / $565.16	Professional		$350.44	$378.49	$565.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.97 / $110.84 / $200.55	Professional	26	$105.97	$110.84	$200.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.28 / $256.45 / $380.04	Professional	TC	$245.28	$256.45	$380.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $465.06 / $465.06 / $465.06	Professional		$465.06	$465.06	$465.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.36 / $337.71 / $675.09	Professional		$126.36	$337.71	$675.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $333.47 / $477.01 / $654.52	Professional		$333.47	$477.01	$654.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.86 / $152.52 / $219.03	Professional	26	$112.86	$152.52	$219.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.04 / $328.89 / $446.36	Professional	TC	$210.04	$328.89	$446.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $345.40 / $543.97 / $989.04	Professional		$345.40	$543.97	$989.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $120.29 / $172.86 / $320.68	Professional	26	$120.29	$172.86	$320.68
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $256.01 / $359.43 / $674.00	Professional	TC	$256.01	$359.43	$674.00
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 $404.09 / $408.37 / $447.84	Professional		$404.09	$408.37	$447.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $121.06 / $123.98 / $142.43	Professional	26	$121.06	$123.98	$142.43
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $259.58 / $271.91 / $305.39	Professional	TC	$259.58	$271.91	$305.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $161.05 / $506.40	Professional		$32.34	$161.05	$506.40
United Facility/Professional Professional Modifier Low / Median / High Price $324.12 / $463.54 / $748.80	Professional		$324.12	$463.54	$748.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $113.64 / $158.96 / $237.96	Professional	26	$113.64	$158.96	$237.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $211.07 / $313.57 / $503.58	Professional	TC	$211.07	$313.57	$503.58