Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $173.78 / $323.59	Facility	26	$97.72	$173.78	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $467.74 / $1,023.29	Professional		$346.74	$467.74	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $165.96 / $363.08	Professional	26	$93.33	$165.96	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $338.84 / $630.96	Professional	TC	$251.19	$338.84	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $107.15 / $151.36	Professional	26	$89.13	$107.15	$151.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $416.87 / $891.25	Professional		$131.83	$416.87	$891.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $549.54 / $851.14	Professional		$389.05	$549.54	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $141.25 / $204.17	Professional	26	$95.50	$141.25	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $416.87 / $660.69	Professional	TC	$288.40	$416.87	$660.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $707.95 / $1,949.84	Professional		$380.19	$707.95	$1,949.84
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $194.98 / $724.44	Professional	26	$112.20	$194.98	$724.44
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $416.87 / $1,230.27	Professional	TC	$288.40	$416.87	$1,230.27
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 $467.74 / $489.78 / $524.81	Professional		$467.74	$489.78	$524.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $131.83 / $138.04	Professional	26	$128.82	$131.83	$138.04
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $338.84 / $380.19	Professional	TC	$323.59	$338.84	$380.19
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 $436.52 / $562.34 / $812.83	Professional		$436.52	$562.34	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $138.04 / $194.98	Professional	26	$104.71	$138.04	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $426.58 / $616.60	Professional	TC	$331.13	$426.58	$616.60