Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.26 / $188.29 / $270.82	Facility	26	$115.26	$188.29	$270.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $340.63 / $475.00 / $1,320.50	Professional		$340.63	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $157.83 / $515.10	Professional	26	$111.15	$157.83	$515.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $228.22 / $335.00 / $483.51	Professional	TC	$228.22	$335.00	$483.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $192.98 / $293.39 / $571.35	Professional		$192.98	$293.39	$571.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.69 / $123.01 / $149.22	Professional	26	$80.69	$123.01	$149.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $74.87 / $203.93 / $259.92	Professional	TC	$74.87	$203.93	$259.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.34 / $377.71 / $664.47	Professional		$138.34	$377.71	$664.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.58 / $147.58 / $147.58	Facility	26	$147.58	$147.58	$147.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.25 / $525.00 / $1,382.31	Professional		$325.25	$525.00	$1,382.31
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 $212.37 / $362.03 / $1,120.83	Professional	TC	$212.37	$362.03	$1,120.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $358.16 / $569.79 / $3,332.12	Professional		$358.16	$569.79	$3,332.12
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.51 / $187.87 / $740.75	Professional	26	$131.51	$187.87	$740.75
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $243.93 / $376.36 / $2,562.11	Professional	TC	$243.93	$376.36	$2,562.11
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 $384.40 / $391.08 / $423.28	Professional		$384.40	$391.08	$423.28
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 $248.72 / $259.58 / $279.58	Professional	TC	$248.72	$259.58	$279.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $150.33 / $442.82	Professional		$32.34	$150.33	$442.82
United Facility/Professional Professional Modifier Low / Median / High Price $356.74 / $581.65 / $1,166.99	Professional		$356.74	$581.65	$1,166.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.56 / $140.75 / $230.66	Professional	26	$114.56	$140.75	$230.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $252.80 / $426.87 / $902.50	Professional	TC	$252.80	$426.87	$902.50