Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.26 / $181.52 / $270.82	Facility	26	$115.26	$181.52	$270.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $353.49 / $475.00 / $1,320.50	Professional		$353.49	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.44 / $157.37 / $518.70	Professional	26	$114.44	$157.37	$518.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $226.87 / $335.00 / $462.42	Professional	TC	$226.87	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.37 / $257.14 / $583.95	Professional		$193.37	$257.14	$583.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.17 / $121.04 / $149.22	Professional	26	$81.17	$121.04	$149.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $184.14 / $260.73 / $260.73	Professional	TC	$184.14	$260.73	$260.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.34 / $378.47 / $665.80	Professional		$138.34	$378.47	$665.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $159.75 / $159.75 / $159.75	Facility	26	$159.75	$159.75	$159.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.89 / $525.00 / $1,404.08	Professional		$325.89	$525.00	$1,404.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.30 / $154.76 / $231.29	Professional	26	$92.30	$154.76	$231.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.02 / $363.12 / $1,120.83	Professional	TC	$213.02	$363.12	$1,120.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $358.90 / $570.97 / $3,896.13	Professional		$358.90	$570.97	$3,896.13
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.51 / $187.92 / $724.96	Professional	26	$131.51	$187.92	$724.96
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $244.69 / $383.82 / $3,231.51	Professional	TC	$244.69	$383.82	$3,231.51
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 $385.16 / $391.89 / $424.15	Professional		$385.16	$391.89	$424.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.51 / $135.68 / $143.69	Professional	26	$131.51	$135.68	$143.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $249.48 / $260.38 / $280.44	Professional	TC	$249.48	$260.38	$280.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $150.33 / $443.73	Professional		$32.34	$150.33	$443.73
United Facility/Professional Professional Modifier Low / Median / High Price $370.17 / $633.52 / $1,216.29	Professional		$370.17	$633.52	$1,216.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.66 / $149.72 / $234.58	Professional	26	$116.66	$149.72	$234.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.51 / $426.96 / $932.52	Professional	TC	$253.51	$426.96	$932.52