Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.22 / $152.59 / $168.57	Facility	26	$91.22	$152.59	$168.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.08 / $392.47 / $568.96	Professional		$257.08	$392.47	$568.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.23 / $96.08 / $209.81	Professional	26	$82.23	$96.08	$209.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $171.98 / $310.24 / $396.58	Professional	TC	$171.98	$310.24	$396.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $184.13 / $184.13 / $184.85	Professional		$184.13	$184.13	$184.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.98 / $85.02 / $122.28	Professional	26	$62.98	$85.02	$122.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.86 / $359.97 / $690.07	Professional		$108.86	$359.97	$690.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.50 / $118.50 / $118.50	Facility	26	$118.50	$118.50	$118.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.79 / $462.51 / $781.14	Professional		$278.79	$462.51	$781.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.80 / $117.43 / $178.64	Professional	26	$72.80	$117.43	$178.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.50 / $336.49 / $630.10	Professional	TC	$192.50	$336.49	$630.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $345.40 / $529.23 / $1,734.93	Professional		$345.40	$529.23	$1,734.93
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.41 / $148.00 / $615.13	Professional	26	$99.41	$148.00	$615.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $254.46 / $381.89 / $1,261.58	Professional	TC	$254.46	$381.89	$1,261.58
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 $366.34 / $374.53 / $404.70	Professional		$366.34	$374.53	$404.70
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $103.68 / $106.89 / $113.09	Professional	26	$103.68	$106.89	$113.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $259.45 / $270.83 / $291.63	Professional	TC	$259.45	$270.83	$291.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $115.11 / $366.70	Professional		$32.34	$115.11	$366.70
United Facility/Professional Professional Modifier Low / Median / High Price $325.52 / $525.14 / $798.59	Professional		$325.52	$525.14	$798.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.02 / $114.99 / $189.38	Professional	26	$91.02	$114.99	$189.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $228.45 / $351.76 / $577.09	Professional	TC	$228.45	$351.76	$577.09