Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $151.36 / $426.58	Facility	26	$89.13	$151.36	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $501.19 / $1,513.56	Professional		$346.74	$501.19	$1,513.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $125.89 / $331.13	Professional	26	$85.11	$125.89	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $346.74 / $691.83	Professional	TC	$257.04	$346.74	$691.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	26	$120.23	$120.23	$120.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $389.05 / $758.58	Professional		$107.15	$389.05	$758.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	26	$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $524.81 / $933.25	Professional		$338.84	$524.81	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $123.03 / $181.97	Professional	26	$72.44	$123.03	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $398.11 / $758.58	Professional	TC	$251.19	$398.11	$758.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $724.44 / $2,630.27	Professional		$371.54	$724.44	$2,630.27
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $165.96 / $707.95	Professional	26	$102.33	$165.96	$707.95
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $575.44 / $2,041.74	Professional	TC	$288.40	$575.44	$2,041.74
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 $398.11 / $407.38 / $446.68	Professional		$398.11	$407.38	$446.68
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $107.15 / $112.20	Professional	26	$102.33	$107.15	$112.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $309.03 / $331.13	Professional	TC	$295.12	$309.03	$331.13
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 $371.54 / $537.03 / $794.33	Professional		$371.54	$537.03	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $107.15 / $162.18	Professional	26	$81.28	$107.15	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $416.87 / $660.69	Professional	TC	$281.84	$416.87	$660.69