Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.26 / $188.13 / $270.82	Facility	26	$115.26	$188.13	$270.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.18 / $475.00 / $1,263.99	Professional		$354.18	$475.00	$1,263.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.50 / $154.00 / $489.70	Professional	26	$112.50	$154.00	$489.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $227.54 / $335.00 / $462.42	Professional	TC	$227.54	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.52 / $245.38 / $316.33	Professional		$194.52	$245.38	$316.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.69 / $109.27 / $147.51	Professional	26	$80.69	$109.27	$147.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $261.54 / $261.54 / $261.54	Professional	TC	$261.54	$261.54	$261.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.34 / $379.22 / $667.13	Professional		$138.34	$379.22	$667.13
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 $324.92 / $518.20 / $1,347.48	Professional		$324.92	$518.20	$1,347.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.87 / $152.55 / $231.92	Professional	26	$90.87	$152.55	$231.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.68 / $347.88 / $1,120.83	Professional	TC	$213.68	$347.88	$1,120.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $359.62 / $572.13 / $3,384.44	Professional		$359.62	$572.13	$3,384.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.51 / $187.87 / $764.38	Professional	26	$131.51	$187.87	$764.38
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $245.44 / $385.00 / $2,603.14	Professional	TC	$245.44	$385.00	$2,603.14
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 $385.93 / $392.69 / $425.01	Professional		$385.93	$392.69	$425.01
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 $250.25 / $261.18 / $281.29	Professional	TC	$250.25	$261.18	$281.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $150.33 / $444.62	Professional		$32.34	$150.33	$444.62
United Facility/Professional Professional Modifier Low / Median / High Price $372.01 / $635.28 / $1,179.76	Professional		$372.01	$635.28	$1,179.76
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 $254.22 / $424.85 / $906.47	Professional	TC	$254.22	$424.85	$906.47