Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $186.21 / $524.81	Facility	26	$109.65	$186.21	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $562.34 / $2,884.03	Professional		$331.13	$562.34	$2,884.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $186.21 / $524.81	Professional	26	$102.33	$186.21	$524.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $354.81 / $912.01	Professional	TC	$239.88	$354.81	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $263.03 / $478.63	Professional		$223.87	$263.03	$478.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $97.72 / $144.54	Professional	26	$77.62	$97.72	$144.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $263.03 / $323.59	Professional	TC	$177.83	$263.03	$323.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $398.11 / $691.83	Professional		$131.83	$398.11	$691.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	26	$138.04	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $575.44 / $1,318.26	Professional		$346.74	$575.44	$1,318.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $151.36 / $218.78	Professional	26	$89.13	$151.36	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $416.87 / $1,122.02	Professional	TC	$239.88	$416.87	$1,122.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $1,047.13 / $4,265.80	Professional		$371.54	$1,047.13	$4,265.80
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $208.93 / $1,023.29	Professional	26	$125.89	$208.93	$1,023.29
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $776.25 / $3,162.28	Professional	TC	$269.15	$776.25	$3,162.28
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 $407.38 / $416.87 / $446.68	Professional		$407.38	$416.87	$446.68
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $128.82 / $138.04	Professional	26	$125.89	$128.82	$138.04
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $288.40 / $309.03	Professional	TC	$275.42	$288.40	$309.03
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 $380.19 / $660.69 / $1,288.25	Professional		$380.19	$660.69	$1,288.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $131.83 / $204.17	Professional	26	$100.00	$131.83	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $478.63 / $1,071.52	Professional	TC	$269.15	$478.63	$1,071.52