Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.45 / $146.63 / $204.77	Facility	26	$87.45	$146.63	$204.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.58 / $456.02 / $609.97	Professional		$318.58	$456.02	$609.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.19 / $119.82 / $154.00	Professional	26	$85.19	$119.82	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $236.28 / $335.00 / $463.34	Professional	TC	$236.28	$335.00	$463.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $182.18 / $198.77	Professional		$182.18	$182.18	$198.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.67 / $65.67 / $104.46	Professional	26	$65.67	$65.67	$104.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.73 / $354.74 / $680.03	Professional		$102.73	$354.74	$680.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.78 / $106.78 / $106.78	Facility	26	$106.78	$106.78	$106.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $308.25 / $492.73 / $919.25	Professional		$308.25	$492.73	$919.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.93 / $113.10 / $170.91	Professional	26	$68.93	$113.10	$170.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.86 / $377.25 / $738.46	Professional	TC	$221.86	$377.25	$738.46
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $345.40 / $536.80 / $2,207.06	Professional		$345.40	$536.80	$2,207.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $98.51 / $140.08 / $699.23	Professional	26	$98.51	$140.08	$699.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $254.85 / $399.76 / $1,616.37	Professional	TC	$254.85	$399.76	$1,616.37
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 $361.01 / $370.06 / $398.78	Professional		$361.01	$370.06	$398.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $98.81 / $101.17 / $106.72	Professional	26	$98.81	$101.17	$106.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $259.83 / $271.25 / $292.06	Professional	TC	$259.83	$271.25	$292.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $111.64 / $417.18	Professional		$32.34	$111.64	$417.18
United Facility/Professional Professional Modifier Low / Median / High Price $357.16 / $575.27 / $884.12	Professional		$357.16	$575.27	$884.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.19 / $109.17 / $174.94	Professional	26	$84.19	$109.17	$174.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $265.62 / $469.36 / $730.31	Professional	TC	$265.62	$469.36	$730.31