Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $669.26 / $734.50 / $1,469.00	Facility		$669.26	$734.50	$1,469.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $183.85 / $183.85 / $183.85	Facility	26	$183.85	$183.85	$183.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $485.41 / $485.41 / $485.41	Facility	TC	$485.41	$485.41	$485.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.93 / $248.97 / $491.94	Professional		$198.93	$248.97	$491.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.76 / $87.38 / $253.70	Professional	26	$67.76	$87.38	$253.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.18 / $180.42 / $356.80	Professional	TC	$131.18	$180.42	$356.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $132.84 / $326.69	Professional		$120.00	$132.84	$326.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.43 / $44.56 / $106.07	Professional	26	$35.43	$44.56	$106.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $147.24 / $147.24 / $147.24	Professional	TC	$147.24	$147.24	$147.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.13 / $269.72 / $444.97	Professional		$87.13	$269.72	$444.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.33 / $144.76 / $463.44	Professional		$88.33	$144.76	$463.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.45 / $43.58 / $131.16	Professional	26	$37.45	$43.58	$131.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.96 / $103.72 / $337.65	Professional	TC	$43.96	$103.72	$337.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $277.05 / $400.74 / $701.71	Professional		$277.05	$400.74	$701.71
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.43 / $128.51 / $367.00	Professional	26	$86.43	$128.51	$367.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $145.21 / $267.37 / $503.35	Professional	TC	$145.21	$267.37	$503.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $388.97	Professional		$32.34	$32.34	$388.97
United Facility/Professional Professional Modifier Low / Median / High Price $175.57 / $263.27 / $418.62	Professional		$175.57	$263.27	$418.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.52 / $84.54 / $129.93	Professional	26	$53.52	$84.54	$129.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.05 / $178.82 / $318.48	Professional	TC	$122.05	$178.82	$318.48