Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $123.03 / $346.74	Facility	26	$74.13	$123.03	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $478.63 / $1,659.59	Professional		$269.15	$478.63	$1,659.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $123.03 / $288.40	Professional	26	$70.79	$123.03	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $316.23 / $630.96	Professional	TC	$199.53	$316.23	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $275.42 / $588.84	Professional		$87.10	$275.42	$588.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Facility	26	$91.20	$91.20	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $436.52 / $794.33	Professional		$269.15	$436.52	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $100.00 / $151.36	Professional	26	$58.88	$100.00	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $316.23 / $630.96	Professional	TC	$199.53	$316.23	$630.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $645.65 / $2,691.53	Professional		$295.12	$645.65	$2,691.53
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $138.04 / $660.69	Professional	26	$83.18	$138.04	$660.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $537.03 / $2,089.30	Professional	TC	$223.87	$537.03	$2,089.30
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 $316.23 / $323.59 / $346.74	Professional		$316.23	$323.59	$346.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $87.10 / $91.20	Professional	26	$85.11	$87.10	$91.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $234.42 / $257.04	Professional	TC	$229.09	$234.42	$257.04
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 $295.12 / $446.68 / $741.31	Professional		$295.12	$446.68	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $87.10 / $138.04	Professional	26	$67.61	$87.10	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $354.81 / $602.56	Professional	TC	$223.87	$354.81	$602.56