Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $117.49 / $181.97	Facility	26	$61.66	$117.49	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $794.33	Professional		$194.98	$295.12	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $87.10 / $245.47	Professional	26	$56.23	$87.10	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $208.93 / $446.68	Professional	TC	$134.90	$208.93	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $147.91 / $177.83	Professional		$87.10	$147.91	$177.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $54.95 / $81.28	Professional	26	$44.67	$54.95	$81.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $102.33 / $204.17	Professional	TC	$102.33	$102.33	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $199.53 / $446.68	Professional		$74.13	$199.53	$446.68
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 $199.53 / $323.59 / $616.60	Professional		$199.53	$323.59	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $85.11 / $128.82	Professional	26	$51.29	$85.11	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $234.42 / $489.78	Professional	TC	$138.04	$234.42	$489.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $549.54 / $1,862.09	Professional		$223.87	$549.54	$1,862.09
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $645.65	Professional	26	$70.79	$120.23	$645.65
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $407.38 / $1,318.26	Professional	TC	$162.18	$407.38	$1,318.26
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 $234.42 / $239.88 / $257.04	Professional		$234.42	$239.88	$257.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $74.13 / $77.62	Professional	26	$70.79	$74.13	$77.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $169.82 / $181.97	Professional	TC	$162.18	$169.82	$181.97
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 $223.87 / $363.08 / $575.44	Professional		$223.87	$363.08	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $81.28 / $125.89	Professional	26	$60.26	$81.28	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $263.03 / $478.63	Professional	TC	$154.88	$263.03	$478.63