Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.51 / $99.49 / $275.33	Facility	26	$69.51	$99.49	$275.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.53 / $298.57 / $1,031.00	Professional		$215.53	$298.57	$1,031.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.52 / $88.98 / $287.61	Professional	26	$62.52	$88.98	$287.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.75 / $185.80 / $327.56	Professional	TC	$152.75	$185.80	$327.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.78 / $236.51 / $236.51	Professional		$183.78	$236.51	$236.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.20 / $72.22 / $72.22	Professional	26	$66.20	$72.22	$72.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $202.68 / $430.64	Professional		$66.73	$202.68	$430.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.49 / $292.56 / $432.74	Professional		$216.49	$292.56	$432.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.16 / $86.11 / $129.76	Professional	26	$63.16	$86.11	$129.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $156.06 / $209.03 / $309.67	Professional	TC	$156.06	$209.03	$309.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $229.56 / $328.97 / $929.79	Professional		$229.56	$328.97	$929.79
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.20 / $93.28 / $327.79	Professional	26	$66.20	$93.28	$327.79
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.16 / $232.26 / $594.08	Professional	TC	$165.16	$232.26	$594.08
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 $253.55 / $260.07 / $279.51	Professional		$253.55	$260.07	$279.51
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $73.73 / $74.63 / $78.23	Professional	26	$73.73	$74.63	$78.23
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $178.92 / $186.34 / $201.29	Professional	TC	$178.92	$186.34	$201.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $81.84 / $292.41	Professional		$32.34	$81.84	$292.41
United Facility/Professional Professional Modifier Low / Median / High Price $223.69 / $293.51 / $474.21	Professional		$223.69	$293.51	$474.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.58 / $88.94 / $139.80	Professional	26	$64.58	$88.94	$139.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.93 / $218.26 / $343.90	Professional	TC	$154.93	$218.26	$343.90