Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.43 / $203.07 / $270.14	Facility	26	$120.43	$203.07	$270.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.14 / $264.42 / $380.51	Professional		$213.14	$264.42	$380.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.06 / $121.37 / $202.32	Professional	26	$100.06	$121.37	$202.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.89 / $126.49 / $206.95	Professional	TC	$99.89	$126.49	$206.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.97 / $309.97 / $309.97	Professional		$309.97	$309.97	$309.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $86.52 / $86.52 / $86.52	Professional	26	$86.52	$86.52	$86.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.47 / $482.88 / $925.67	Professional		$144.47	$482.88	$925.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $143.15 / $143.15 / $143.15	Facility	26	$143.15	$143.15	$143.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $359.61 / $569.04 / $909.03	Professional		$359.61	$569.04	$909.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.96 / $150.08 / $227.96	Professional	26	$90.96	$150.08	$227.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $261.05 / $422.82 / $685.55	Professional	TC	$261.05	$422.82	$685.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $459.29 / $680.42 / $1,540.34	Professional		$459.29	$680.42	$1,540.34
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $127.00 / $174.56 / $362.97	Professional	26	$127.00	$174.56	$362.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $332.30 / $453.14 / $949.77	Professional	TC	$332.30	$453.14	$949.77
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 $491.41 / $503.15 / $542.79	Professional		$491.41	$503.15	$542.79
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $127.57 / $137.74 / $150.09	Professional	26	$127.57	$137.74	$150.09
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $333.81 / $349.58 / $392.72	Professional	TC	$333.81	$349.58	$392.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $136.09 / $305.51	Professional		$32.34	$136.09	$305.51
United Facility/Professional Professional Modifier Low / Median / High Price $420.56 / $582.04 / $920.82	Professional		$420.56	$582.04	$920.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $111.21 / $144.94 / $229.79	Professional	26	$111.21	$144.94	$229.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $311.27 / $435.30 / $719.81	Professional	TC	$311.27	$435.30	$719.81