Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $251.19 / $478.63	Facility	26	$141.25	$251.19	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $302.00 / $707.95	Professional		$245.47	$302.00	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $229.09 / $549.54	Professional	26	$131.83	$229.09	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $147.91 / $269.15	Professional	TC	$109.65	$147.91	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $123.03 / $229.09	Professional	26	$112.20	$123.03	$229.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $354.81 / $660.69	Professional		$194.98	$354.81	$660.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $380.19 / $549.54	Professional		$257.04	$380.19	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $204.17 / $295.12	Professional	26	$138.04	$204.17	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $181.97 / $257.04	Professional	TC	$125.89	$181.97	$257.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $512.86 / $1,621.81	Professional		$295.12	$512.86	$1,621.81
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $281.84 / $954.99	Professional	26	$162.18	$281.84	$954.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $194.98 / $758.58	Professional	TC	$138.04	$194.98	$758.58
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 $346.74 / $354.81 / $380.19	Professional		$346.74	$354.81	$380.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $190.55 / $204.17	Professional	26	$186.21	$190.55	$204.17
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $158.49 / $177.83	Professional	TC	$151.36	$158.49	$177.83
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 $295.12 / $371.54 / $524.81	Professional		$295.12	$371.54	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $194.98 / $275.42	Professional	26	$151.36	$194.98	$275.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $173.78 / $245.47	Professional	TC	$134.90	$173.78	$245.47