Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.12 / $173.54 / $259.16	Facility	26	$110.12	$173.54	$259.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.26 / $475.00 / $1,320.50	Professional		$347.26	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.61 / $151.65 / $504.90	Professional	26	$109.61	$151.65	$504.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $250.39 / $335.00 / $512.32	Professional	TC	$250.39	$335.00	$512.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $221.05 / $254.54 / $344.00	Professional		$221.05	$254.54	$344.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.28 / $104.48 / $141.05	Professional	26	$77.28	$104.48	$141.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $202.30 / $202.30 / $202.30	Professional	TC	$202.30	$202.30	$202.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.19 / $396.79 / $698.03	Professional		$132.19	$396.79	$698.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.77 / $138.77 / $138.77	Facility	26	$138.77	$138.77	$138.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.79 / $558.33 / $1,327.33	Professional		$344.79	$558.33	$1,327.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.37 / $147.02 / $218.41	Professional	26	$88.37	$147.02	$218.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $233.98 / $399.00 / $1,137.66	Professional	TC	$233.98	$399.00	$1,137.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $376.79 / $599.45 / $3,775.24	Professional		$376.79	$599.45	$3,775.24
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.97 / $179.57 / $715.66	Professional	26	$125.97	$179.57	$715.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $268.76 / $421.58 / $3,014.83	Professional	TC	$268.76	$421.58	$3,014.83
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 $403.81 / $412.11 / $445.30	Professional		$403.81	$412.11	$445.30
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.97 / $129.78 / $137.32	Professional	26	$125.97	$129.78	$137.32
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $274.02 / $286.14 / $307.97	Professional	TC	$274.02	$286.14	$307.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $143.66 / $465.85	Professional		$32.34	$143.66	$465.85
United Facility/Professional Professional Modifier Low / Median / High Price $396.60 / $661.74 / $1,167.33	Professional		$396.60	$661.74	$1,167.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.96 / $140.41 / $241.19	Professional	26	$109.96	$140.41	$241.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.64 / $477.46 / $971.87	Professional	TC	$281.64	$477.46	$971.87