Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $97.72 / $199.53	Facility	26	$69.18	$97.72	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $331.13 / $1,174.90	Professional		$186.21	$331.13	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $107.15 / $302.00	Professional	26	$61.66	$107.15	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $190.55 / $512.86	Professional	TC	$117.49	$190.55	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $144.54 / $295.12	Professional		$134.90	$144.54	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $60.26 / $97.72	Professional	26	$48.98	$60.26	$97.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $112.20 / $162.18	Professional	TC	$83.18	$112.20	$162.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $204.17 / $416.87	Professional		$81.28	$204.17	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $85.11 / $85.11	Facility	26	$85.11	$85.11	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $288.40 / $524.81	Professional		$186.21	$288.40	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $89.13 / $131.83	Professional	26	$56.23	$89.13	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $194.98 / $371.54	Professional	TC	$120.23	$194.98	$371.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $407.38 / $1,621.81	Professional		$208.93	$407.38	$1,621.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $131.83 / $549.54	Professional	26	$77.62	$131.83	$549.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $275.42 / $1,096.48	Professional	TC	$138.04	$275.42	$1,096.48
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 $223.87 / $223.87 / $245.47	Professional		$223.87	$223.87	$245.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $81.28 / $85.11	Professional	26	$79.43	$81.28	$85.11
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $147.91 / $158.49	Professional	TC	$141.25	$147.91	$158.49
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 $194.98 / $295.12 / $436.52	Professional		$194.98	$295.12	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $81.28 / $125.89	Professional	26	$63.10	$81.28	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $204.17 / $338.84	Professional	TC	$128.82	$204.17	$338.84