Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $102.33 / $173.78	Facility	26	$60.26	$102.33	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $426.58 / $1,096.48	Professional		$218.78	$426.58	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $112.20 / $295.12	Professional	26	$57.54	$112.20	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $288.40 / $562.34	Professional	TC	$162.18	$288.40	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $181.97 / $199.53	Professional		$154.88	$181.97	$199.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $52.48 / $79.43	Professional	26	$41.69	$52.48	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $204.17 / $204.17	Professional	TC	$204.17	$204.17	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $251.19 / $457.09	Professional		$70.79	$251.19	$457.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	26	$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $416.87 / $776.25	Professional		$223.87	$416.87	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $81.28 / $128.82	Professional	26	$47.86	$81.28	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $302.00 / $707.95	Professional	TC	$169.82	$302.00	$707.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $588.84 / $2,290.87	Professional		$245.47	$588.84	$2,290.87
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $109.65 / $660.69	Professional	26	$67.61	$109.65	$660.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $512.86 / $1,905.46	Professional	TC	$186.21	$512.86	$1,905.46
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 $257.04 / $263.03 / $281.84	Professional		$257.04	$263.03	$281.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $69.18 / $74.13	Professional	26	$69.18	$69.18	$74.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $194.98 / $208.93	Professional	TC	$186.21	$194.98	$208.93
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 $234.42 / $436.52 / $758.58	Professional		$234.42	$436.52	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $70.79 / $109.65	Professional	26	$54.95	$70.79	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $331.13 / $660.69	Professional	TC	$177.83	$331.13	$660.69