Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $199.53 / $199.53	Facility	26	$104.71	$199.53	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $380.19 / $758.58	Professional		$338.84	$380.19	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $120.23 / $208.93	Professional	26	$97.72	$120.23	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $269.15 / $426.58	Professional	TC	$229.09	$269.15	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $338.84 / $676.08	Professional		$125.89	$338.84	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $467.74 / $741.31	Professional		$346.74	$467.74	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $154.88 / $245.47	Professional	26	$112.20	$154.88	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $323.59 / $467.74	Professional	TC	$229.09	$323.59	$467.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $537.03 / $1,000.00	Professional		$338.84	$537.03	$1,000.00
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $165.96 / $323.59	Professional	26	$112.20	$165.96	$323.59
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $331.13 / $645.65	Professional	TC	$234.42	$331.13	$645.65
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 $407.38 / $407.38 / $446.68	Professional		$407.38	$407.38	$446.68
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $123.03 / $141.25	Professional	26	$120.23	$123.03	$141.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $269.15 / $302.00	Professional	TC	$257.04	$269.15	$302.00
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 $323.59 / $426.58 / $707.95	Professional		$323.59	$426.58	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $147.91 / $234.42	Professional	26	$112.20	$147.91	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $281.84 / $489.78	Professional	TC	$208.93	$281.84	$489.78