Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.43 / $317.68 / $638.57	Facility	26	$208.43	$317.68	$638.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $395.51 / $489.24 / $1,145.60	Professional		$395.51	$489.24	$1,145.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $188.34 / $295.33 / $628.66	Professional	26	$188.34	$295.33	$628.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $197.83 / $270.72 / $474.31	Professional	TC	$197.83	$270.72	$474.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $367.94 / $478.03 / $497.79	Professional		$367.94	$478.03	$497.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $164.59 / $240.03 / $308.61	Professional	26	$164.59	$240.03	$308.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $286.08 / $558.19 / $1,070.05	Professional		$286.08	$558.19	$1,070.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $452.79 / $647.72 / $984.14	Professional		$452.79	$647.72	$984.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $219.74 / $308.61 / $484.38	Professional	26	$219.74	$308.61	$484.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $244.22 / $337.34 / $522.11	Professional	TC	$244.22	$337.34	$522.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $480.67 / $764.70 / $1,913.92	Professional		$480.67	$764.70	$1,913.92
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $237.26 / $365.76 / $1,224.66	Professional	26	$237.26	$365.76	$1,224.66
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $243.41 / $349.20 / $745.05	Professional	TC	$243.41	$349.20	$745.05
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 $568.05 / $575.42 / $621.44	Professional		$568.05	$575.42	$621.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $277.33 / $280.39 / $297.18	Professional	26	$277.33	$280.39	$297.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.62 / $287.66 / $324.26	Professional	TC	$275.62	$287.66	$324.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $306.80 / $650.12	Professional		$32.34	$306.80	$650.12
United Facility/Professional Professional Modifier Low / Median / High Price $493.24 / $628.23 / $994.83	Professional		$493.24	$628.23	$994.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $229.42 / $301.86 / $576.23	Professional	26	$229.42	$301.86	$576.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.82 / $345.38 / $532.11	Professional	TC	$263.82	$345.38	$532.11