Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $177.83 / $309.03	Facility	26	$107.15	$177.83	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $478.63 / $1,778.28	Professional		$181.97	$478.63	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $181.97 / $524.81	Professional	26	$100.00	$181.97	$524.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $354.81 / $870.96	Professional	TC	$245.47	$354.81	$870.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $257.04 / $302.00	Professional		$223.87	$257.04	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $97.72 / $141.25	Professional	26	$75.86	$97.72	$141.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $302.00 / $346.74	Professional	TC	$302.00	$302.00	$346.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $398.11 / $758.58	Professional		$128.82	$398.11	$758.58
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 $346.74 / $575.44 / $1,258.93	Professional		$346.74	$575.44	$1,258.93
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 $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 / $1,023.29 / $3,388.44	Professional		$371.54	$1,023.29	$3,388.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $194.98 / $1,445.44	Professional	26	$120.23	$194.98	$1,445.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $758.58 / $2,691.53	Professional	TC	$269.15	$758.58	$2,691.53
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 $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 $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 / $1,258.93	Professional		$380.19	$660.69	$1,258.93
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 $269.15 / $478.63 / $1,047.13	Professional	TC	$269.15	$478.63	$1,047.13