Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.32 / $186.60 / $219.36	Facility	26	$118.32	$186.60	$219.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $284.20 / $414.14 / $589.47	Professional		$284.20	$414.14	$589.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.37 / $122.79 / $378.95	Professional	26	$104.37	$122.79	$378.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.48 / $289.61 / $388.21	Professional	TC	$170.48	$289.61	$388.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $248.28 / $310.35 / $395.81	Professional		$248.28	$310.35	$395.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $84.68 / $104.45 / $153.16	Professional	26	$84.68	$104.45	$153.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.99 / $446.83 / $926.76	Professional		$141.99	$446.83	$926.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $148.54 / $148.54 / $148.54	Facility	26	$148.54	$148.54	$148.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.88 / $614.74 / $996.79	Professional		$344.88	$614.74	$996.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.84 / $153.18 / $232.50	Professional	26	$92.84	$153.18	$232.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.11 / $457.09 / $806.08	Professional	TC	$251.11	$457.09	$806.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $460.01 / $701.50 / $2,225.54	Professional		$460.01	$701.50	$2,225.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.33 / $193.19 / $896.91	Professional	26	$135.33	$193.19	$896.91
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $339.66 / $516.48 / $1,422.33	Professional	TC	$339.66	$516.48	$1,422.33
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 $492.00 / $503.30 / $543.65	Professional		$492.00	$503.30	$543.65
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.33 / $139.53 / $147.50	Professional	26	$135.33	$139.53	$147.50
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $352.46 / $367.97 / $396.15	Professional	TC	$352.46	$367.97	$396.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $154.31 / $402.71	Professional		$32.34	$154.31	$402.71
United Facility/Professional Professional Modifier Low / Median / High Price $442.18 / $615.74 / $969.88	Professional		$442.18	$615.74	$969.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.59 / $146.84 / $246.36	Professional	26	$116.59	$146.84	$246.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $315.98 / $445.14 / $763.17	Professional	TC	$315.98	$445.14	$763.17