Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.51 / $152.00 / $186.36	Facility	26	$100.51	$152.00	$186.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.94 / $434.03 / $1,088.00	Professional		$342.94	$434.03	$1,088.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.53 / $118.21 / $334.40	Professional	26	$84.53	$118.21	$334.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $247.82 / $313.22 / $499.76	Professional	TC	$247.82	$313.22	$499.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $237.22 / $310.12 / $403.16	Professional		$237.22	$310.12	$403.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.69 / $88.06 / $129.36	Professional	26	$69.69	$88.06	$129.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $193.94 / $211.66 / $340.92	Professional	TC	$193.94	$211.66	$340.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.92 / $342.37 / $762.18	Professional		$119.92	$342.37	$762.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.67 / $121.67 / $121.67	Facility	26	$121.67	$121.67	$121.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $300.00 / $501.58 / $745.81	Professional		$300.00	$501.58	$745.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.45 / $129.36 / $191.50	Professional	26	$79.45	$129.36	$191.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $215.42 / $370.21 / $560.78	Professional	TC	$215.42	$370.21	$560.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $378.00 / $560.25 / $2,467.81	Professional		$378.00	$560.25	$2,467.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $110.08 / $163.30 / $772.35	Professional	26	$110.08	$163.30	$772.35
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $272.60 / $396.95 / $1,695.46	Professional	TC	$272.60	$396.95	$1,695.46
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 $404.63 / $414.31 / $446.73	Professional		$404.63	$414.31	$446.73
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.89 / $117.94 / $124.57	Professional	26	$114.89	$117.94	$124.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $286.69 / $299.42 / $322.17	Professional	TC	$286.69	$299.42	$322.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $130.32 / $467.35	Professional		$32.34	$130.32	$467.35
United Facility/Professional Professional Modifier Low / Median / High Price $369.86 / $488.57 / $706.88	Professional		$369.86	$488.57	$706.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.54 / $125.00 / $204.98	Professional	26	$97.54	$125.00	$204.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $268.11 / $357.51 / $543.94	Professional	TC	$268.11	$357.51	$543.94