Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $323.29 / $323.29 / $323.29	Facility	26	$323.29	$323.29	$323.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.18 / $374.18 / $729.65	Professional		$300.18	$374.18	$729.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.76 / $141.88 / $335.75	Professional	26	$112.76	$141.88	$335.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.94 / $254.47 / $493.05	Professional	TC	$181.94	$254.47	$493.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.00 / $190.00 / $198.72	Professional		$190.00	$190.00	$198.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $88.53 / $160.72	Professional	26	$62.17	$88.53	$160.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $204.72 / $204.72 / $204.72	Professional	TC	$204.72	$204.72	$204.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.22 / $430.26 / $665.79	Professional		$153.22	$430.26	$665.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.29 / $216.52 / $702.91	Professional		$114.29	$216.52	$702.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.94 / $74.09 / $231.35	Professional	26	$65.94	$74.09	$231.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.52 / $144.84 / $474.95	Professional	TC	$60.52	$144.84	$474.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $396.45 / $575.11 / $917.25	Professional		$396.45	$575.11	$917.25
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $151.97 / $221.06 / $509.57	Professional	26	$151.97	$221.06	$509.57
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $103.24 / $357.22 / $680.47	Professional	TC	$103.24	$357.22	$680.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $187.90 / $626.23	Professional		$32.34	$187.90	$626.23
United Facility/Professional Professional Modifier Low / Median / High Price $266.27 / $375.32 / $615.25	Professional		$266.27	$375.32	$615.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.28 / $150.58 / $276.31	Professional	26	$94.28	$150.58	$276.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.00 / $228.57 / $389.85	Professional	TC	$165.00	$228.57	$389.85