Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.78 / $116.12 / $175.51	Facility	26	$74.78	$116.12	$175.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.81 / $375.00 / $820.20	Professional		$209.81	$375.00	$820.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.90 / $126.00 / $409.45	Professional	26	$70.90	$126.00	$409.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.72 / $236.18 / $433.05	Professional	TC	$128.72	$236.18	$433.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.74 / $150.30 / $194.09	Professional		$126.74	$150.30	$194.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.19 / $56.48 / $94.55	Professional	26	$48.19	$56.48	$94.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $96.76 / $96.76 / $96.76	Professional	TC	$96.76	$96.76	$96.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.41 / $226.07 / $397.70	Professional		$88.41	$226.07	$397.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.49 / $99.49 / $99.49	Facility	26	$99.49	$99.49	$99.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.67 / $323.16 / $795.34	Professional		$194.67	$323.16	$795.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.60 / $98.90 / $154.50	Professional	26	$59.60	$98.90	$154.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.15 / $207.23 / $596.41	Professional	TC	$122.15	$207.23	$596.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $219.68 / $345.40 / $2,143.90	Professional		$219.68	$345.40	$2,143.90
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.78 / $120.47 / $476.79	Professional	26	$84.78	$120.47	$476.79
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $140.30 / $220.08 / $1,704.24	Professional	TC	$140.30	$220.08	$1,704.24
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 $230.06 / $234.12 / $252.71	Professional		$230.06	$234.12	$252.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.94 / $87.01 / $91.85	Professional	26	$84.94	$87.01	$91.85
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $143.05 / $149.18 / $160.86	Professional	TC	$143.05	$149.18	$160.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $96.08 / $264.37	Professional		$32.34	$96.08	$264.37
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $373.16 / $656.58	Professional		$218.78	$373.16	$656.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.34 / $94.59 / $152.30	Professional	26	$75.34	$94.59	$152.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.78 / $240.46 / $520.75	Professional	TC	$142.78	$240.46	$520.75