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 $234.00 / $475.00 / $946.56	Professional		$234.00	$475.00	$946.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.07 / $143.00 / $389.19	Professional	26	$108.07	$143.00	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $284.75 / $348.97 / $567.22	Professional	TC	$284.75	$348.97	$567.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.40 / $280.70 / $369.20	Professional		$231.40	$280.70	$369.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.61 / $123.01 / $139.97	Professional	26	$77.61	$123.01	$139.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.74 / $428.48 / $863.59	Professional		$129.74	$428.48	$863.59
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 $389.88 / $608.21 / $1,355.62	Professional		$389.88	$608.21	$1,355.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.62 / $141.57 / $208.19	Professional	26	$85.62	$141.57	$208.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $282.77 / $453.53 / $1,113.90	Professional	TC	$282.77	$453.53	$1,113.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $428.87 / $682.29 / $3,509.55	Professional		$428.87	$682.29	$3,509.55
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.47 / $176.26 / $900.48	Professional	26	$123.47	$176.26	$900.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $324.81 / $509.50 / $2,750.46	Professional	TC	$324.81	$509.50	$2,750.46
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 $458.46 / $469.56 / $506.84	Professional		$458.46	$469.56	$506.84
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 $331.18 / $346.10 / $372.07	Professional	TC	$331.18	$346.10	$372.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $141.00 / $530.24	Professional		$32.34	$141.00	$530.24
United Facility/Professional Professional Modifier Low / Median / High Price $453.44 / $703.53 / $1,217.11	Professional		$453.44	$703.53	$1,217.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $137.34 / $236.64	Professional	26	$100.00	$137.34	$236.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $344.71 / $548.88 / $961.64	Professional	TC	$344.71	$548.88	$961.64