Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.07 / $175.79 / $254.11	Facility	26	$108.07	$175.79	$254.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.00 / $494.18 / $996.90	Professional		$279.00	$494.18	$996.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.07 / $140.00 / $324.42	Professional	26	$108.07	$140.00	$324.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $304.92 / $361.95 / $641.16	Professional	TC	$304.92	$361.95	$641.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $277.08 / $325.24 / $420.20	Professional		$277.08	$325.24	$420.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.95 / $101.30 / $133.31	Professional	26	$74.95	$101.30	$133.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.74 / $412.76 / $918.87	Professional		$129.74	$412.76	$918.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.69 / $132.69 / $132.69	Facility	26	$132.69	$132.69	$132.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.51 / $647.95 / $1,324.60	Professional		$416.51	$647.95	$1,324.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.91 / $140.19 / $211.53	Professional	26	$85.91	$140.19	$211.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $307.82 / $486.21 / $1,144.63	Professional	TC	$307.82	$486.21	$1,144.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $456.89 / $726.86 / $3,090.64	Professional		$456.89	$726.86	$3,090.64
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $122.40 / $176.26 / $862.62	Professional	26	$122.40	$176.26	$862.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $353.58 / $545.44 / $2,302.05	Professional	TC	$353.58	$545.44	$2,302.05
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 $487.80 / $499.89 / $539.96	Professional		$487.80	$499.89	$539.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.47 / $127.30 / $134.78	Professional	26	$123.47	$127.30	$134.78
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $360.52 / $376.42 / $405.18	Professional	TC	$360.52	$376.42	$405.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $141.00 / $564.88	Professional		$32.34	$141.00	$564.88
United Facility/Professional Professional Modifier Low / Median / High Price $482.53 / $743.51 / $1,239.63	Professional		$482.53	$743.51	$1,239.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.57 / $137.34 / $209.45	Professional	26	$104.57	$137.34	$209.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $368.64 / $602.84 / $1,007.43	Professional	TC	$368.64	$602.84	$1,007.43