Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.26 / $113.87 / $124.79	Facility	26	$72.26	$113.87	$124.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.33 / $370.50 / $522.50	Professional		$194.33	$370.50	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.30 / $113.81 / $154.00	Professional	26	$67.30	$113.81	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $127.02 / $203.27 / $348.53	Professional	TC	$127.02	$203.27	$348.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.38 / $179.07 / $179.07	Professional		$132.38	$179.07	$179.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.67 / $84.18 / $100.31	Professional	26	$79.67	$84.18	$100.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.96 / $234.55 / $494.89	Professional		$94.96	$234.55	$494.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.98 / $310.97 / $473.34	Professional		$206.98	$310.97	$473.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.28 / $102.44 / $154.94	Professional	26	$63.28	$102.44	$154.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.51 / $208.21 / $322.56	Professional	TC	$140.51	$208.21	$322.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $249.46 / $370.94 / $1,517.84	Professional		$249.46	$370.94	$1,517.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.47 / $115.18 / $474.20	Professional	26	$83.47	$115.18	$474.20
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $160.86 / $219.36 / $764.61	Professional	TC	$160.86	$219.36	$764.61
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 $262.72 / $268.14 / $288.76	Professional		$262.72	$268.14	$288.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.85 / $91.60 / $98.64	Professional	26	$83.85	$91.60	$98.64
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $161.60 / $169.13 / $190.11	Professional	TC	$161.60	$169.13	$190.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $103.20 / $302.08	Professional		$32.34	$103.20	$302.08
United Facility/Professional Professional Modifier Low / Median / High Price $253.90 / $451.90 / $1,075.25	Professional		$253.90	$451.90	$1,075.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.20 / $101.50 / $158.44	Professional	26	$79.20	$101.50	$158.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.63 / $301.32 / $929.70	Professional	TC	$171.63	$301.32	$929.70