Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.68 / $170.01 / $242.94	Facility	26	$89.68	$170.01	$242.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.92 / $324.02 / $601.95	Professional		$290.92	$324.02	$601.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.57 / $95.50 / $178.57	Professional	26	$89.57	$95.50	$178.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $201.24 / $228.53 / $426.90	Professional	TC	$201.24	$228.53	$426.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $124.58 / $124.58 / $124.58	Professional	26	$124.58	$124.58	$124.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.93 / $404.72 / $775.84	Professional		$129.93	$404.72	$775.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.20 / $466.07 / $657.78	Professional		$321.20	$466.07	$657.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.88 / $140.16 / $220.82	Professional	26	$99.88	$140.16	$220.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $219.02 / $322.27 / $460.30	Professional	TC	$219.02	$322.27	$460.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $348.51 / $552.52 / $1,598.63	Professional		$348.51	$552.52	$1,598.63
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.87 / $155.72 / $458.00	Professional	26	$107.87	$155.72	$458.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $246.15 / $354.40 / $773.90	Professional	TC	$246.15	$354.40	$773.90
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 $411.88 / $422.51 / $454.96	Professional		$411.88	$422.51	$454.96
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.72 / $126.44 / $134.97	Professional	26	$114.72	$126.44	$134.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $272.00 / $284.39 / $320.00	Professional	TC	$272.00	$284.39	$320.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $152.62 / $475.96	Professional		$32.34	$152.62	$475.96
United Facility/Professional Professional Modifier Low / Median / High Price $329.90 / $427.05 / $686.95	Professional		$329.90	$427.05	$686.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.58 / $139.31 / $207.82	Professional	26	$102.58	$139.31	$207.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.68 / $294.16 / $475.01	Professional	TC	$217.68	$294.16	$475.01