Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.73 / $135.49 / $189.45	Facility	26	$78.73	$135.49	$189.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.18 / $404.05 / $617.23	Professional		$339.18	$404.05	$617.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.03 / $89.51 / $182.44	Professional	26	$77.03	$89.51	$182.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.72 / $327.11 / $465.40	Professional	TC	$263.72	$327.11	$465.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $397.93 / $444.52 / $508.47	Professional		$397.93	$444.52	$508.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $86.16 / $111.26 / $127.36	Professional	26	$86.16	$111.26	$127.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.32 / $304.47 / $677.30	Professional		$93.32	$304.47	$677.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.38 / $96.38 / $96.38	Facility	26	$96.38	$96.38	$96.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $308.32 / $596.90 / $865.96	Professional		$308.32	$596.90	$865.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.69 / $119.39 / $193.44	Professional	26	$86.69	$119.39	$193.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.31 / $480.89 / $688.21	Professional	TC	$216.31	$480.89	$688.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $383.52 / $609.26 / $995.53	Professional		$383.52	$609.26	$995.53
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.02 / $123.38 / $407.22	Professional	26	$87.02	$123.38	$407.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $286.39 / $462.00 / $735.90	Professional	TC	$286.39	$462.00	$735.90
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 $517.66 / $535.13 / $574.79	Professional		$517.66	$535.13	$574.79
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.38 / $103.48 / $109.38	Professional	26	$102.38	$103.48	$109.38
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $414.21 / $432.76 / $465.40	Professional	TC	$414.21	$432.76	$465.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $79.59 / $557.49	Professional		$32.34	$79.59	$557.49
United Facility/Professional Professional Modifier Low / Median / High Price $332.16 / $502.61 / $848.33	Professional		$332.16	$502.61	$848.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.27 / $118.96 / $191.07	Professional	26	$82.27	$118.96	$191.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.55 / $393.07 / $659.41	Professional	TC	$244.55	$393.07	$659.41