Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.07 / $175.25 / $254.11	Facility	26	$108.07	$175.25	$254.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.91 / $475.00 / $1,079.23	Professional		$222.91	$475.00	$1,079.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.06 / $142.13 / $386.00	Professional	26	$108.06	$142.13	$386.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.75 / $335.00 / $572.30	Professional	TC	$252.75	$335.00	$572.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $202.97 / $256.76 / $344.57	Professional		$202.97	$256.76	$344.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.75 / $123.01 / $145.62	Professional	26	$75.75	$123.01	$145.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.74 / $396.98 / $761.01	Professional		$129.74	$396.98	$761.01
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 $344.96 / $571.38 / $1,273.96	Professional		$344.96	$571.38	$1,273.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.29 / $139.96 / $211.53	Professional	26	$85.29	$139.96	$211.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $236.27 / $408.07 / $1,134.81	Professional	TC	$236.27	$408.07	$1,134.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $377.18 / $600.05 / $3,166.48	Professional		$377.18	$600.05	$3,166.48
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $122.40 / $176.26 / $694.51	Professional	26	$122.40	$176.26	$694.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $271.39 / $425.72 / $2,529.33	Professional	TC	$271.39	$425.72	$2,529.33
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 $404.00 / $412.43 / $445.76	Professional		$404.00	$412.43	$445.76
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 $276.72 / $288.95 / $310.99	Professional	TC	$276.72	$288.95	$310.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $141.00 / $466.33	Professional		$32.34	$141.00	$466.33
United Facility/Professional Professional Modifier Low / Median / High Price $395.14 / $660.48 / $1,237.67	Professional		$395.14	$660.48	$1,237.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.20 / $133.18 / $204.32	Professional	26	$104.20	$133.18	$204.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $283.77 / $480.41 / $915.85	Professional	TC	$283.77	$480.41	$915.85