Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.07 / $187.64 / $221.29	Facility	26	$119.07	$187.64	$221.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $280.95 / $364.49 / $750.80	Professional		$280.95	$364.49	$750.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.31 / $134.80 / $322.08	Professional	26	$100.31	$134.80	$322.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.16 / $235.21 / $388.21	Professional	TC	$170.16	$235.21	$388.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $196.21 / $253.49 / $311.64	Professional		$196.21	$253.49	$311.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.38 / $136.96 / $167.46	Professional	26	$81.38	$136.96	$167.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.83 / $382.64 / $733.51	Professional		$142.83	$382.64	$733.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.84 / $140.84 / $140.84	Facility	26	$140.84	$140.84	$140.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.61 / $502.66 / $857.07	Professional		$309.61	$502.66	$857.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.81 / $150.44 / $226.13	Professional	26	$92.81	$150.44	$226.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.00 / $331.71 / $625.90	Professional	TC	$210.00	$331.71	$625.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $362.47 / $550.29 / $2,001.52	Professional		$362.47	$550.29	$2,001.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.08 / $194.53 / $765.89	Professional	26	$131.08	$194.53	$765.89
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $226.20 / $323.07 / $1,008.46	Professional	TC	$226.20	$323.07	$1,008.46
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 $389.40 / $396.11 / $428.38	Professional		$389.40	$396.11	$428.38
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $136.80 / $140.49 / $148.37	Professional	26	$136.80	$140.49	$148.37
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $237.99 / $248.91 / $279.99	Professional	TC	$237.99	$248.91	$279.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $155.22 / $448.15	Professional		$32.34	$155.22	$448.15
United Facility/Professional Professional Modifier Low / Median / High Price $361.92 / $556.22 / $909.04	Professional		$361.92	$556.22	$909.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.54 / $147.54 / $245.15	Professional	26	$114.54	$147.54	$245.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.40 / $387.26 / $656.66	Professional	TC	$242.40	$387.26	$656.66