Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.42 / $77.48 / $92.21	Facility	26	$49.42	$77.48	$92.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.66 / $221.75 / $516.26	Professional		$134.66	$221.75	$516.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $60.40 / $239.31	Professional	26	$44.14	$60.40	$239.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.11 / $146.90 / $240.00	Professional	TC	$86.11	$146.90	$240.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $94.66 / $127.39	Professional		$78.45	$94.66	$127.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.61 / $39.77 / $63.17	Professional	26	$34.61	$39.77	$63.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.04 / $44.04 / $58.80	Professional	TC	$44.04	$44.04	$58.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.94 / $153.08 / $269.30	Professional		$58.94	$153.08	$269.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.76 / $62.76 / $62.76	Facility	26	$62.76	$62.76	$62.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.02 / $213.57 / $427.44	Professional		$133.02	$213.57	$427.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.14 / $65.94 / $99.09	Professional	26	$40.14	$65.94	$99.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.34 / $141.90 / $320.05	Professional	TC	$83.34	$141.90	$320.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $149.15 / $236.65 / $1,365.12	Professional		$149.15	$236.65	$1,365.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.52 / $82.43 / $369.86	Professional	26	$56.52	$82.43	$369.86
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.58 / $143.43 / $1,111.80	Professional	TC	$93.58	$143.43	$1,111.80
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 $155.79 / $159.04 / $170.91	Professional		$155.79	$159.04	$170.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.10 / $58.18 / $61.23	Professional	26	$57.10	$58.18	$61.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.60 / $101.95 / $109.68	Professional	TC	$97.60	$101.95	$109.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $64.06 / $178.80	Professional		$32.34	$64.06	$178.80
United Facility/Professional Professional Modifier Low / Median / High Price $156.05 / $252.80 / $391.95	Professional		$156.05	$252.80	$391.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.48 / $62.21 / $101.02	Professional	26	$50.48	$62.21	$101.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.66 / $176.64 / $286.13	Professional	TC	$102.66	$176.64	$286.13