Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.12 / $173.54 / $259.16	Facility	26	$110.12	$173.54	$259.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $355.24 / $475.00 / $1,320.50	Professional		$355.24	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.61 / $154.00 / $540.90	Professional	26	$109.61	$154.00	$540.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.74 / $335.00 / $515.04	Professional	TC	$251.74	$335.00	$515.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.97 / $307.02 / $403.03	Professional		$229.97	$307.02	$403.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.94 / $104.48 / $142.60	Professional	26	$76.94	$104.48	$142.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.19 / $398.30 / $763.53	Professional		$132.19	$398.30	$763.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.35 / $138.35 / $138.35	Facility	26	$138.35	$138.35	$138.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.10 / $560.49 / $1,284.44	Professional		$346.10	$560.49	$1,284.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.37 / $147.02 / $217.76	Professional	26	$88.37	$147.02	$217.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $235.29 / $401.17 / $1,130.91	Professional	TC	$235.29	$401.17	$1,130.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $378.25 / $601.76 / $3,800.78	Professional		$378.25	$601.76	$3,800.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.97 / $179.69 / $753.11	Professional	26	$125.97	$179.69	$753.11
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $270.26 / $423.94 / $3,118.96	Professional	TC	$270.26	$423.94	$3,118.96
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 $405.34 / $413.73 / $447.02	Professional		$405.34	$413.73	$447.02
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.97 / $129.78 / $137.32	Professional	26	$125.97	$129.78	$137.32
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.56 / $287.74 / $309.69	Professional	TC	$275.56	$287.74	$309.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $143.66 / $467.65	Professional		$32.34	$143.66	$467.65
United Facility/Professional Professional Modifier Low / Median / High Price $396.94 / $675.99 / $1,222.67	Professional		$396.94	$675.99	$1,222.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.57 / $141.15 / $241.19	Professional	26	$109.57	$141.15	$241.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $282.36 / $478.05 / $972.29	Professional	TC	$282.36	$478.05	$972.29