Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $97.72 / $213.80	Facility	26	$74.13	$97.72	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $616.60	Professional		$131.83	$177.83	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $95.50 / $281.84	Professional	26	$58.88	$95.50	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $97.72 / $234.42	Professional	TC	$67.61	$97.72	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $91.20	Professional		$83.18	$83.18	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $66.07 / $100.00	Professional	26	$51.29	$66.07	$100.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $158.49 / $288.40	Professional		$87.10	$158.49	$288.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	26	$69.18	$69.18	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $194.98 / $371.54	Professional		$123.03	$194.98	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $85.11 / $131.83	Professional	26	$53.70	$85.11	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $93.33 / $281.84	Professional	TC	$56.23	$93.33	$281.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $288.40 / $1,202.26	Professional		$144.54	$288.40	$1,202.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $141.25 / $660.69	Professional	26	$81.28	$141.25	$660.69
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $81.28 / $676.08	Professional	TC	$58.88	$81.28	$676.08
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 $151.36 / $151.36 / $165.96	Professional		$151.36	$151.36	$165.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $87.10 / $91.20	Professional	26	$83.18	$87.10	$91.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $66.07 / $74.13	Professional	TC	$63.10	$66.07	$74.13
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 $134.90 / $194.98 / $380.19	Professional		$134.90	$194.98	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $75.86 / $134.90	Professional	26	$56.23	$75.86	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $104.71 / $269.15	Professional	TC	$70.79	$104.71	$269.15