Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $208.93 / $380.19	Facility	26	$128.82	$208.93	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $549.54 / $2,454.71	Professional		$371.54	$549.54	$2,454.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $218.78 / $602.56	Professional	26	$117.49	$218.78	$602.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $346.74 / $776.25	Professional	TC	$251.19	$346.74	$776.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $138.04 / $190.55	Professional	26	$91.20	$138.04	$190.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $426.58 / $812.83	Professional		$154.88	$426.58	$812.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $162.18 / $162.18	Facility	26	$162.18	$162.18	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $562.34 / $1,047.13	Professional		$363.08	$562.34	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $165.96 / $257.04	Professional	26	$104.71	$165.96	$257.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $398.11 / $812.83	Professional	TC	$245.47	$398.11	$812.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $851.14 / $3,981.07	Professional		$389.05	$851.14	$3,981.07
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $269.15 / $1,071.52	Professional	26	$141.25	$269.15	$1,071.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $363.08 / $2,511.89	Professional	TC	$263.03	$363.08	$2,511.89
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 $436.52 / $446.68 / $478.63	Professional		$436.52	$446.68	$478.63
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $151.36 / $158.49	Professional	26	$147.91	$151.36	$158.49
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $281.84 / $316.23	Professional	TC	$269.15	$281.84	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $616.60 / $1,023.29	Professional		$407.38	$616.60	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $151.36 / $234.42	Professional	26	$114.82	$151.36	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $446.68 / $776.25	Professional	TC	$275.42	$446.68	$776.25