Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.93 / $151.94 / $213.12	Facility	26	$105.93	$151.94	$213.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $366.24 / $475.00 / $895.94	Professional		$366.24	$475.00	$895.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.89 / $140.00 / $306.99	Professional	26	$90.89	$140.00	$306.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $266.48 / $335.00 / $645.84	Professional	TC	$266.48	$335.00	$645.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $208.26 / $260.33 / $451.70	Professional		$208.26	$260.33	$451.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.41 / $102.43 / $115.24	Professional	26	$64.41	$102.43	$115.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.83 / $383.20 / $776.96	Professional		$106.83	$383.20	$776.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.84 / $110.84 / $110.84	Facility	26	$110.84	$110.84	$110.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.19 / $584.88 / $1,294.18	Professional		$352.19	$584.88	$1,294.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.67 / $118.14 / $180.00	Professional	26	$71.67	$118.14	$180.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $262.31 / $443.36 / $1,115.07	Professional	TC	$262.31	$443.36	$1,115.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $386.14 / $614.32 / $3,147.52	Professional		$386.14	$614.32	$3,147.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.43 / $145.75 / $853.55	Professional	26	$102.43	$145.75	$853.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $301.30 / $472.62 / $2,415.94	Professional	TC	$301.30	$472.62	$2,415.94
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 $412.46 / $423.45 / $456.35	Professional		$412.46	$423.45	$456.35
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.96 / $105.26 / $110.97	Professional	26	$102.96	$105.26	$110.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $307.20 / $320.49 / $345.38	Professional	TC	$307.20	$320.49	$345.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $116.09 / $477.41	Professional		$32.34	$116.09	$477.41
United Facility/Professional Professional Modifier Low / Median / High Price $392.45 / $712.62 / $1,135.53	Professional		$392.45	$712.62	$1,135.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.27 / $110.10 / $188.68	Professional	26	$88.27	$110.10	$188.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $300.45 / $557.07 / $1,027.89	Professional	TC	$300.45	$557.07	$1,027.89