Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.26 / $190.50 / $280.31	Facility	26	$118.26	$190.50	$280.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $565.67 / $720.29 / $1,138.79	Professional		$565.67	$720.29	$1,138.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.70 / $138.83 / $372.11	Professional	26	$112.70	$138.83	$372.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $277.07 / $320.37 / $436.24	Professional	52	$277.07	$320.37	$436.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $450.89 / $602.07 / $960.19	Professional	TC	$450.89	$602.07	$960.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $108.48 / $139.32 / $156.10	Professional	26	$108.48	$139.32	$156.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.76 / $533.22 / $986.46	Professional		$128.76	$533.22	$986.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.97 / $133.97 / $133.97	Facility	26	$133.97	$133.97	$133.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $627.87 / $889.48 / $1,388.15	Professional		$627.87	$889.48	$1,388.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.91 / $177.64 / $271.68	Professional	26	$121.91	$177.64	$271.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $507.65 / $717.86 / $1,138.08	Professional	TC	$507.65	$717.86	$1,138.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $609.92 / $944.64 / $2,941.78	Professional		$609.92	$944.64	$2,941.78
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $121.76 / $185.76 / $714.05	Professional	26	$121.76	$185.76	$714.05
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $495.74 / $727.94 / $2,234.60	Professional	TC	$495.74	$727.94	$2,234.60
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 $694.89 / $735.35 / $817.52	Professional		$694.89	$735.35	$817.52
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.29 / $142.05 / $150.93	Professional	26	$128.29	$142.05	$150.93
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $566.60 / $591.45 / $666.59	Professional	TC	$566.60	$591.45	$666.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $154.97 / $791.91	Professional		$32.34	$154.97	$791.91
United Facility/Professional Professional Modifier Low / Median / High Price $589.41 / $903.49 / $1,445.58	Professional		$589.41	$903.49	$1,445.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $113.85 / $183.81 / $298.68	Professional	26	$113.85	$183.81	$298.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $466.41 / $718.27 / $1,095.52	Professional	TC	$466.41	$718.27	$1,095.52