Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.42 / $53.36 / $96.61	Facility	26	$41.42	$53.36	$96.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.33 / $279.58 / $446.26	Professional		$228.33	$279.58	$446.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.54 / $40.90 / $66.06	Professional	26	$35.54	$40.90	$66.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.82 / $236.99 / $344.73	Professional	TC	$191.82	$236.99	$344.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $209.46 / $209.46 / $215.15	Professional		$209.46	$209.46	$215.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.65 / $209.81 / $434.65	Professional		$45.65	$209.81	$434.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.21 / $336.51 / $508.06	Professional		$243.21	$336.51	$508.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $53.96 / $77.05	Professional	26	$37.11	$53.96	$77.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.48 / $280.94 / $431.00	Professional	TC	$203.48	$280.94	$431.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $267.08 / $373.91 / $916.52	Professional		$267.08	$373.91	$916.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.34 / $58.25 / $147.18	Professional	26	$41.34	$58.25	$147.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.10 / $286.92 / $666.47	Professional	TC	$208.10	$286.92	$666.47
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 $289.33 / $293.95 / $324.05	Professional		$289.33	$293.95	$324.05
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.50 / $45.48 / $53.51	Professional	26	$43.50	$45.48	$53.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.95 / $240.47 / $270.52	Professional	TC	$229.95	$240.47	$270.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $55.98 / $339.01	Professional		$32.34	$55.98	$339.01
United Facility/Professional Professional Modifier Low / Median / High Price $247.02 / $342.25 / $555.75	Professional		$247.02	$342.25	$555.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.29 / $51.80 / $86.37	Professional	26	$37.29	$51.80	$86.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.85 / $289.10 / $463.99	Professional	TC	$208.85	$289.10	$463.99