Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.90 / $214.78 / $431.83	Facility	26	$140.90	$214.78	$431.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.38 / $269.86 / $505.41	Professional		$244.38	$269.86	$505.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $159.34 / $382.02	Professional	26	$131.81	$159.34	$382.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.74 / $132.43 / $244.81	Professional	TC	$110.74	$132.43	$244.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $305.75 / $305.75 / $305.75	Professional		$305.75	$305.75	$305.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $112.00 / $112.00 / $186.67	Professional	26	$112.00	$112.00	$186.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.68 / $358.79 / $659.35	Professional		$194.68	$358.79	$659.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.02 / $396.69 / $601.22	Professional		$278.02	$396.69	$601.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $148.36 / $210.01 / $326.89	Professional	26	$148.36	$210.01	$326.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $129.66 / $184.32 / $278.60	Professional	TC	$129.66	$184.32	$278.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $296.18 / $470.14 / $1,493.28	Professional		$296.18	$470.14	$1,493.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $166.08 / $248.90 / $938.46	Professional	26	$166.08	$248.90	$938.46
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.28 / $198.84 / $665.20	Professional	TC	$138.28	$198.84	$665.20
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 $350.03 / $353.29 / $381.99	Professional		$350.03	$353.29	$381.99
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $187.75 / $190.48 / $202.23	Professional	26	$187.75	$190.48	$202.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $152.80 / $159.56 / $179.76	Professional	TC	$152.80	$159.56	$179.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $188.06 / $399.62	Professional		$32.34	$188.06	$399.62
United Facility/Professional Professional Modifier Low / Median / High Price $292.92 / $376.88 / $562.96	Professional		$292.92	$376.88	$562.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $152.87 / $204.56 / $313.77	Professional	26	$152.87	$204.56	$313.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.11 / $169.51 / $256.14	Professional	TC	$135.11	$169.51	$256.14