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 / $549.54 / $2,570.40	Professional		$331.13	$549.54	$2,570.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $194.98 / $562.34	Professional	26	$107.15	$194.98	$562.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $338.84 / $794.33	Professional	TC	$218.78	$338.84	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $251.19 / $302.00	Professional		$234.42	$251.19	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $102.33 / $151.36	Professional	26	$81.28	$102.33	$151.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $263.03 / $302.00	Professional	TC	$190.55	$263.03	$302.00
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 / $158.49 / $239.88	Professional	26	$95.50	$158.49	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $371.54 / $1,096.48	Professional	TC	$213.80	$371.54	$1,096.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $977.24 / $3,981.07	Professional		$354.81	$977.24	$3,981.07
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $218.78 / $912.01	Professional	26	$131.83	$218.78	$912.01
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $575.44 / $3,311.31	Professional	TC	$245.47	$575.44	$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 / $602.56 / $1,258.93	Professional		$354.81	$602.56	$1,258.93
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 / $1,023.29	Professional	TC	$239.88	$407.38	$1,023.29