Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $114.82 / $239.88	Facility	26	$69.18	$114.82	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $371.54 / $1,380.38	Professional		$229.09	$371.54	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $100.00 / $251.19	Professional	26	$61.66	$100.00	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $257.04 / $602.56	Professional	TC	$165.96	$257.04	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $204.17 / $407.38	Professional		$190.55	$204.17	$407.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $61.66 / $91.20	Professional	26	$48.98	$61.66	$91.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $162.18 / $251.19	Professional	TC	$141.25	$162.18	$251.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $257.04 / $575.44	Professional		$83.18	$257.04	$575.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $87.10 / $87.10	Facility	26	$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $398.11 / $724.44	Professional		$251.19	$398.11	$724.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $91.20 / $134.90	Professional	26	$56.23	$91.20	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $295.12 / $562.34	Professional	TC	$186.21	$295.12	$562.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $562.34 / $1,819.70	Professional		$295.12	$562.34	$1,819.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $131.83 / $776.25	Professional	26	$77.62	$131.83	$776.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $407.38 / $1,096.48	Professional	TC	$218.78	$407.38	$1,096.48
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 $309.03 / $316.23 / $338.84	Professional		$309.03	$316.23	$338.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $81.28 / $85.11	Professional	26	$79.43	$81.28	$85.11
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $239.88 / $257.04	Professional	TC	$229.09	$239.88	$257.04
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 $269.15 / $398.11 / $616.60	Professional		$269.15	$398.11	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $83.18 / $128.82	Professional	26	$64.57	$83.18	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $309.03 / $512.86	Professional	TC	$194.98	$309.03	$512.86