Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.84 / $82.26 / $144.69	Facility	26	$54.84	$82.26	$144.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.78 / $306.55 / $754.26	Professional		$235.78	$306.55	$754.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.84 / $94.20 / $318.50	Professional	26	$54.84	$94.20	$318.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $218.71 / $357.62	Professional	TC	$162.34	$218.71	$357.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.24 / $200.20 / $287.87	Professional		$169.24	$200.20	$287.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.95 / $46.53 / $75.03	Professional	26	$39.95	$46.53	$75.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $247.34 / $247.34	Professional	TC	$151.36	$247.34	$247.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $222.01 / $459.95	Professional		$61.64	$222.01	$459.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $261.36 / $381.71 / $582.16	Professional		$261.36	$381.71	$582.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.98 / $85.04 / $136.16	Professional	26	$55.98	$85.04	$136.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.37 / $293.14 / $453.64	Professional	TC	$203.37	$293.14	$453.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $280.27 / $400.38 / $904.11	Professional		$280.27	$400.38	$904.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.14 / $88.93 / $408.90	Professional	26	$61.14	$88.93	$408.90
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.02 / $291.58 / $515.29	Professional	TC	$218.02	$291.58	$515.29
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 $306.18 / $313.24 / $340.21	Professional		$306.18	$313.24	$340.21
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.18 / $68.00 / $72.25	Professional	26	$65.18	$68.00	$72.25
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $238.17 / $248.05 / $267.95	Professional	TC	$238.17	$248.05	$267.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $75.59 / $355.91	Professional		$32.34	$75.59	$355.91
United Facility/Professional Professional Modifier Low / Median / High Price $281.27 / $401.28 / $611.35	Professional		$281.27	$401.28	$611.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.83 / $89.78 / $147.37	Professional	26	$58.83	$89.78	$147.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $212.56 / $317.02 / $512.99	Professional	TC	$212.56	$317.02	$512.99