Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.50 / $65.09 / $69.45	Facility	26	$46.50	$65.09	$69.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.92 / $215.98 / $363.48	Professional		$177.92	$215.98	$363.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.16 / $50.01 / $93.19	Professional	26	$44.16	$50.01	$93.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.41 / $164.46 / $258.36	Professional	TC	$131.41	$164.46	$258.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.13 / $96.03 / $135.28	Professional		$60.13	$96.03	$135.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.80 / $66.59 / $70.65	Professional	26	$62.80	$66.59	$70.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.48 / $234.10 / $448.76	Professional		$65.48	$234.10	$448.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.91 / $293.58 / $525.00	Professional		$193.91	$293.58	$525.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $70.65 / $107.25	Professional	26	$43.65	$70.65	$107.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.33 / $214.54 / $332.36	Professional	TC	$144.33	$214.54	$332.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $226.65 / $344.32 / $1,408.76	Professional		$226.65	$344.32	$1,408.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.56 / $79.38 / $306.56	Professional	26	$57.56	$79.38	$306.56
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.23 / $225.32 / $868.33	Professional	TC	$165.23	$225.32	$868.33
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 $238.24 / $244.41 / $263.30	Professional		$238.24	$244.41	$263.30
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.82 / $63.05 / $68.03	Professional	26	$57.82	$63.05	$68.03
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.98 / $173.73 / $195.27	Professional	TC	$165.98	$173.73	$195.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $71.17 / $275.45	Professional		$32.34	$71.17	$275.45
United Facility/Professional Professional Modifier Low / Median / High Price $223.99 / $297.36 / $472.06	Professional		$223.99	$297.36	$472.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.50 / $69.40 / $106.75	Professional	26	$55.50	$69.40	$106.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.35 / $221.97 / $333.66	Professional	TC	$167.35	$221.97	$333.66