Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.84 / $125.84 / $138.61	Facility	26	$75.84	$125.84	$138.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.40 / $151.37 / $261.92	Professional		$125.40	$151.37	$261.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.68 / $82.73 / $155.49	Professional	26	$70.68	$82.73	$155.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.53 / $61.75 / $94.39	Professional	TC	$51.53	$61.75	$94.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.69 / $166.12 / $182.01	Professional		$133.69	$166.12	$182.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.73 / $80.17 / $104.76	Professional	26	$69.73	$80.17	$104.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.06 / $130.13 / $188.26	Professional		$86.06	$130.13	$188.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.73 / $88.73 / $88.73	Facility	26	$88.73	$88.73	$88.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.38 / $186.99 / $304.01	Professional		$136.38	$186.99	$304.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.15 / $108.64 / $172.76	Professional	26	$80.15	$108.64	$172.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.58 / $80.34 / $135.03	Professional	TC	$56.58	$80.34	$135.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $132.52 / $198.78 / $769.20	Professional		$132.52	$198.78	$769.20
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.14 / $110.21 / $268.39	Professional	26	$77.14	$110.21	$268.39
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.27 / $74.14 / $156.69	Professional	TC	$51.27	$74.14	$156.69
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 $158.99 / $160.90 / $172.28	Professional		$158.99	$160.90	$172.28
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.75 / $94.76 / $100.88	Professional	26	$85.75	$94.76	$100.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.69 / $63.48 / $71.40	Professional	TC	$60.69	$63.48	$71.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $48.83 / $171.22	Professional		$32.34	$48.83	$171.22
United Facility/Professional Professional Modifier Low / Median / High Price $133.82 / $200.86 / $313.95	Professional		$133.82	$200.86	$313.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.45 / $112.42 / $176.82	Professional	26	$75.45	$112.42	$176.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.27 / $87.21 / $137.13	Professional	TC	$58.27	$87.21	$137.13