Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $181.97 / $316.23	Facility	26	$107.15	$181.97	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $537.03 / $1,995.26	Professional		$239.88	$537.03	$1,995.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $181.97 / $501.19	Professional	26	$102.33	$181.97	$501.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $416.87 / $1,023.29	Professional	TC	$281.84	$416.87	$1,023.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $302.00 / $380.19	Professional		$251.19	$302.00	$380.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $95.50 / $147.91	Professional	26	$75.86	$95.50	$147.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $363.08 / $363.08	Professional	TC	$363.08	$363.08	$363.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $380.19 / $870.96	Professional		$128.82	$380.19	$870.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $616.60 / $1,288.25	Professional		$389.05	$616.60	$1,288.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $144.54 / $213.80	Professional	26	$87.10	$144.54	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $467.74 / $1,096.48	Professional	TC	$295.12	$467.74	$1,096.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $1,071.52 / $3,981.07	Professional		$426.58	$1,071.52	$3,981.07
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $199.53 / $1,071.52	Professional	26	$123.03	$199.53	$1,071.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $891.25 / $3,090.30	Professional	TC	$323.59	$891.25	$3,090.30
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 $457.09 / $467.74 / $512.86	Professional		$457.09	$467.74	$512.86
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $125.89 / $134.90	Professional	26	$123.03	$125.89	$134.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $346.74 / $371.54	Professional	TC	$331.13	$346.74	$371.54
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 $436.52 / $691.83 / $1,288.25	Professional		$436.52	$691.83	$1,288.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $125.89 / $199.53	Professional	26	$97.72	$125.89	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $537.03 / $1,071.52	Professional	TC	$323.59	$537.03	$1,071.52