Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.82 / $168.08 / $184.23	Facility	26	$100.82	$168.08	$184.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.30 / $192.34 / $331.95	Professional		$161.30	$192.34	$331.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.46 / $110.56 / $212.74	Professional	26	$94.46	$110.56	$212.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.56 / $79.31 / $121.87	Professional	TC	$65.56	$79.31	$121.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.69 / $207.94 / $290.99	Professional		$158.69	$207.94	$290.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $92.92 / $124.16 / $139.68	Professional	26	$92.92	$124.16	$139.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.75 / $173.44 / $246.15	Professional		$114.75	$173.44	$246.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.19 / $118.19 / $118.19	Facility	26	$118.19	$118.19	$118.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.18 / $244.98 / $400.16	Professional		$178.18	$244.98	$400.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.09 / $144.85 / $231.27	Professional	26	$107.09	$144.85	$231.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.89 / $103.48 / $171.68	Professional	TC	$71.89	$103.48	$171.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $173.28 / $259.92 / $913.54	Professional		$173.28	$259.92	$913.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.81 / $146.87 / $345.37	Professional	26	$102.81	$146.87	$345.37
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $65.20 / $95.01 / $413.63	Professional	TC	$65.20	$95.01	$413.63
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 $208.01 / $210.37 / $225.26	Professional		$208.01	$210.37	$225.26
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.33 / $126.13 / $134.51	Professional	26	$114.33	$126.13	$134.51
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.14 / $80.73 / $90.75	Professional	TC	$77.14	$80.73	$90.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $62.10 / $224.01	Professional		$32.34	$62.10	$224.01
United Facility/Professional Professional Modifier Low / Median / High Price $176.05 / $249.90 / $401.35	Professional		$176.05	$249.90	$401.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.04 / $150.28 / $236.17	Professional	26	$100.04	$150.28	$236.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.01 / $116.17 / $176.02	Professional	TC	$76.01	$116.17	$176.02