Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.56 / $99.46 / $133.41	Facility	26	$66.56	$99.46	$133.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.46 / $486.08 / $1,160.23	Professional		$370.46	$486.08	$1,160.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.33 / $76.59 / $201.60	Professional	26	$67.33	$76.59	$201.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $303.13 / $388.38 / $695.26	Professional	TC	$303.13	$388.38	$695.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $306.39 / $306.39 / $471.14	Professional		$306.39	$306.39	$471.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.47 / $79.11 / $104.28	Professional	26	$53.47	$79.11	$104.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.31 / $336.74 / $928.86	Professional		$93.31	$336.74	$928.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $382.84 / $589.79 / $985.52	Professional		$382.84	$589.79	$985.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.13 / $104.39 / $169.47	Professional	26	$67.13	$104.39	$169.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $334.06 / $485.41 / $815.32	Professional	TC	$334.06	$485.41	$815.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $410.66 / $610.87 / $1,912.33	Professional		$410.66	$610.87	$1,912.33
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.27 / $114.08 / $524.94	Professional	26	$78.27	$114.08	$524.94
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.98 / $499.28 / $1,518.07	Professional	TC	$338.98	$499.28	$1,518.07
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 $493.10 / $508.43 / $547.67	Professional		$493.10	$508.43	$547.67
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.35 / $92.50 / $96.93	Professional	26	$91.35	$92.50	$96.93
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $400.61 / $417.08 / $450.74	Professional	TC	$400.61	$417.08	$450.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $101.40 / $572.95	Professional		$32.34	$101.40	$572.95
United Facility/Professional Professional Modifier Low / Median / High Price $480.86 / $644.10 / $1,064.65	Professional		$480.86	$644.10	$1,064.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.19 / $106.50 / $161.13	Professional	26	$80.19	$106.50	$161.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $399.76 / $527.58 / $808.72	Professional	TC	$399.76	$527.58	$808.72