Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.50 / $157.51 / $164.45	Facility	26	$89.50	$157.51	$164.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.36 / $232.87 / $333.15	Professional		$141.36	$232.87	$333.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.82 / $87.84 / $164.44	Professional	26	$56.82	$87.84	$164.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.03 / $122.91 / $232.83	Professional	TC	$60.03	$122.91	$232.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.73 / $66.73 / $66.73	Professional	26	$66.73	$66.73	$66.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $209.66 / $374.08	Professional		$120.23	$209.66	$374.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.41 / $256.33 / $641.98	Professional		$148.41	$256.33	$641.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.23 / $110.49 / $174.40	Professional	26	$67.23	$110.49	$174.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.00 / $120.86 / $539.83	Professional	TC	$66.00	$120.86	$539.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $185.12 / $305.52 / $935.91	Professional		$185.12	$305.52	$935.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.17 / $153.72 / $546.54	Professional	26	$102.17	$153.72	$546.54
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $80.87 / $125.57 / $570.50	Professional	TC	$80.87	$125.57	$570.50
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 $193.49 / $198.59 / $217.79	Professional		$193.49	$198.59	$217.79
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.90 / $116.13 / $124.90	Professional	26	$107.90	$116.13	$124.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $82.46 / $85.59 / $92.90	Professional	TC	$82.46	$85.59	$92.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $89.33 / $227.84	Professional		$32.34	$89.33	$227.84
United Facility/Professional Professional Modifier Low / Median / High Price $175.91 / $267.42 / $557.02	Professional		$175.91	$267.42	$557.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.27 / $112.47 / $195.06	Professional	26	$69.27	$112.47	$195.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.91 / $136.07 / $354.26	Professional	TC	$78.91	$136.07	$354.26