Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.52 / $152.04 / $170.41	Facility	26	$90.52	$152.04	$170.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.83 / $475.00 / $668.34	Professional		$349.83	$475.00	$668.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.69 / $128.00 / $173.08	Professional	26	$89.69	$128.00	$173.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $509.42	Professional	TC	$259.35	$335.00	$509.42
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $379.81 / $379.81 / $379.81	Professional	50	$379.81	$379.81	$379.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.03 / $386.30 / $758.34	Professional		$108.03	$386.30	$758.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.06 / $112.06 / $112.06	Facility	26	$112.06	$112.06	$112.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $343.74 / $526.89 / $856.04	Professional		$343.74	$526.89	$856.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.33 / $119.94 / $180.00	Professional	26	$72.33	$119.94	$180.00
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $507.23 / $507.23 / $580.67	Professional	50	$507.23	$507.23	$580.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.14 / $392.31 / $685.80	Professional	TC	$253.14	$392.31	$685.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $377.01 / $599.79 / $2,174.82	Professional		$377.01	$599.79	$2,174.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.87 / $146.93 / $634.35	Professional	26	$102.87	$146.93	$634.35
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $290.76 / $456.10 / $1,634.57	Professional	TC	$290.76	$456.10	$1,634.57
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 $402.58 / $412.09 / $445.56	Professional		$402.58	$412.09	$445.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.87 / $106.12 / $112.23	Professional	26	$102.87	$106.12	$112.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $296.47 / $309.22 / $333.33	Professional	TC	$296.47	$309.22	$333.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $117.41 / $466.13	Professional		$32.34	$117.41	$466.13
United Facility/Professional Professional Modifier Low / Median / High Price $389.69 / $565.75 / $839.52	Professional		$389.69	$565.75	$839.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.95 / $107.33 / $169.74	Professional	26	$87.95	$107.33	$169.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $297.61 / $441.89 / $683.36	Professional	TC	$297.61	$441.89	$683.36