Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $186.21 / $331.13	Facility	26	$114.82	$186.21	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $588.84 / $2,398.83	Professional		$331.13	$588.84	$2,398.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $199.53 / $562.34	Professional	26	$109.65	$199.53	$562.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $338.84 / $891.25	Professional	TC	$218.78	$338.84	$891.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $251.19 / $295.12	Professional		$117.49	$251.19	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $100.00 / $154.88	Professional	26	$81.28	$100.00	$154.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $147.91 / $275.42	Professional	TC	$131.83	$147.91	$275.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $380.19 / $660.69	Professional		$138.04	$380.19	$660.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $537.03 / $1,348.96	Professional		$323.59	$537.03	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $154.88 / $239.88	Professional	26	$95.50	$154.88	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $371.54 / $1,122.02	Professional	TC	$213.80	$371.54	$1,122.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $1,000.00 / $3,981.07	Professional		$354.81	$1,000.00	$3,981.07
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $218.78 / $977.24	Professional	26	$131.83	$218.78	$977.24
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $537.03 / $3,311.31	Professional	TC	$245.47	$537.03	$3,311.31
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 $389.05 / $389.05 / $426.58	Professional		$389.05	$389.05	$426.58
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $134.90 / $144.54	Professional	26	$131.83	$134.90	$144.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $263.03 / $281.84	Professional	TC	$251.19	$263.03	$281.84
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 $354.81 / $616.60 / $1,288.25	Professional		$354.81	$616.60	$1,288.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $141.25 / $213.80	Professional	26	$107.15	$141.25	$213.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $407.38 / $1,071.52	Professional	TC	$239.88	$407.38	$1,071.52