Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.42 / $170.26 / $254.93	Facility	26	$108.42	$170.26	$254.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $476.67 / $941.27	Professional		$375.00	$476.67	$941.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.42 / $140.00 / $284.77	Professional	26	$108.42	$140.00	$284.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $285.67 / $350.12 / $590.45	Professional	TC	$285.67	$350.12	$590.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $252.99 / $303.12 / $370.14	Professional		$252.99	$303.12	$370.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.22 / $108.86 / $145.62	Professional	26	$75.22	$108.86	$145.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.74 / $388.90 / $865.76	Professional		$129.74	$388.90	$865.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.28 / $132.28 / $132.28	Facility	26	$132.28	$132.28	$132.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $390.87 / $609.76 / $1,350.31	Professional		$390.87	$609.76	$1,350.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.91 / $141.57 / $208.19	Professional	26	$85.91	$141.57	$208.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $283.75 / $451.30 / $1,115.63	Professional	TC	$283.75	$451.30	$1,115.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $429.96 / $684.02 / $3,299.21	Professional		$429.96	$684.02	$3,299.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.47 / $176.26 / $961.14	Professional	26	$123.47	$176.26	$961.14
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $325.93 / $511.26 / $2,645.67	Professional	TC	$325.93	$511.26	$2,645.67
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 $459.62 / $470.77 / $508.13	Professional		$459.62	$470.77	$508.13
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 $332.32 / $347.31 / $373.36	Professional	TC	$332.32	$347.31	$373.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $137.09 / $531.58	Professional		$32.34	$137.09	$531.58
United Facility/Professional Professional Modifier Low / Median / High Price $454.15 / $704.63 / $1,203.17	Professional		$454.15	$704.63	$1,203.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.20 / $133.60 / $208.20	Professional	26	$104.20	$133.60	$208.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $345.42 / $579.51 / $957.40	Professional	TC	$345.42	$579.51	$957.40