Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.02 / $151.40 / $297.55	Facility	26	$97.02	$151.40	$297.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.62 / $417.25 / $787.01	Professional		$346.62	$417.25	$787.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.71 / $114.55 / $297.55	Professional	26	$90.71	$114.55	$297.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $254.60 / $323.22 / $563.49	Professional	TC	$254.60	$323.22	$563.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.40 / $83.81 / $128.18	Professional	26	$76.40	$83.81	$128.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.80 / $464.43 / $890.31	Professional		$132.80	$464.43	$890.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $392.66 / $552.45 / $901.01	Professional		$392.66	$552.45	$901.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.50 / $143.25 / $226.65	Professional	26	$102.50	$143.25	$226.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $292.26 / $414.12 / $674.36	Professional	TC	$292.26	$414.12	$674.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $399.93 / $643.07 / $1,807.47	Professional		$399.93	$643.07	$1,807.47
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $111.42 / $175.47 / $572.57	Professional	26	$111.42	$175.47	$572.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $290.95 / $425.95 / $930.00	Professional	TC	$290.95	$425.95	$930.00
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 $472.64 / $487.11 / $522.50	Professional		$472.64	$487.11	$522.50
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $129.34 / $130.35 / $137.94	Professional	26	$129.34	$130.35	$137.94
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $326.86 / $342.29 / $384.54	Professional	TC	$326.86	$342.29	$384.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $155.97 / $546.61	Professional		$32.34	$155.97	$546.61
United Facility/Professional Professional Modifier Low / Median / High Price $437.35 / $576.47 / $920.47	Professional		$437.35	$576.47	$920.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.28 / $137.59 / $258.62	Professional	26	$108.28	$137.59	$258.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $313.56 / $434.39 / $701.57	Professional	TC	$313.56	$434.39	$701.57