Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $141.25 / $288.40	Facility	26	$64.57	$141.25	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $275.42 / $691.83	Professional		$218.78	$275.42	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $70.79 / $154.88	Professional	26	$54.95	$70.79	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $213.80 / $436.52	Professional	TC	$158.49	$213.80	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $245.47 / $478.63	Professional		$77.62	$245.47	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $331.13 / $691.83	Professional		$199.53	$331.13	$691.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $81.28 / $117.49	Professional	26	$54.95	$81.28	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $234.42 / $588.84	Professional	TC	$147.91	$234.42	$588.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $398.11 / $1,778.28	Professional		$218.78	$398.11	$1,778.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $91.20 / $512.86	Professional	26	$64.57	$91.20	$512.86
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $223.87 / $1,023.29	Professional	TC	$154.88	$223.87	$1,023.29
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 $257.04 / $263.03 / $281.84	Professional		$257.04	$263.03	$281.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $74.13 / $81.28	Professional	26	$69.18	$74.13	$81.28
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $181.97 / $204.17	Professional	TC	$173.78	$181.97	$204.17
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 $234.42 / $389.05 / $758.58	Professional		$234.42	$389.05	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $75.86 / $120.23	Professional	26	$58.88	$75.86	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $645.65	Professional	TC	$169.82	$281.84	$645.65