Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.04 / $146.56 / $186.12	Facility	26	$104.04	$146.56	$186.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $307.26 / $475.00 / $963.30	Professional		$307.26	$475.00	$963.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.92 / $140.00 / $563.94	Professional	26	$97.92	$140.00	$563.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $207.01 / $320.70 / $433.05	Professional	TC	$207.01	$320.70	$433.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.79 / $329.54 / $408.20	Professional		$257.79	$329.54	$408.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.83 / $101.19 / $149.66	Professional	26	$79.83	$101.19	$149.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.75 / $347.68 / $773.99	Professional		$138.75	$347.68	$773.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.87 / $505.22 / $747.77	Professional		$331.87	$505.22	$747.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.90 / $149.27 / $221.60	Professional	26	$90.90	$149.27	$221.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.54 / $343.45 / $532.13	Professional	TC	$229.54	$343.45	$532.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $383.27 / $581.88 / $2,499.46	Professional		$383.27	$581.88	$2,499.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $127.50 / $188.48 / $726.97	Professional	26	$127.50	$188.48	$726.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $261.32 / $356.34 / $1,301.66	Professional	TC	$261.32	$356.34	$1,301.66
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 $410.89 / $418.87 / $452.96	Professional		$410.89	$418.87	$452.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.91 / $136.10 / $144.13	Professional	26	$131.91	$136.10	$144.13
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $262.50 / $274.79 / $308.83	Professional	TC	$262.50	$274.79	$308.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $150.78 / $473.86	Professional		$32.34	$150.78	$473.86
United Facility/Professional Professional Modifier Low / Median / High Price $400.07 / $660.05 / $1,275.93	Professional		$400.07	$660.05	$1,275.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.37 / $126.23 / $223.34	Professional	26	$86.37	$126.23	$223.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $280.98 / $478.63 / $948.20	Professional	TC	$280.98	$478.63	$948.20