Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $194.98 / $229.09	Facility	26	$125.89	$194.98	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $302.00 / $831.76	Professional		$199.53	$302.00	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $173.78 / $524.81	Professional	26	$120.23	$173.78	$524.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $93.33 / $181.97	Professional	TC	$75.86	$93.33	$181.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $204.17 / $288.40	Professional		$177.83	$204.17	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $134.90 / $181.97	Professional	26	$117.49	$134.90	$181.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $295.12	Professional		$144.54	$218.78	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $295.12 / $467.74	Professional		$218.78	$295.12	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $177.83 / $275.42	Professional	26	$131.83	$177.83	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $117.49 / $190.55	Professional	TC	$83.18	$117.49	$190.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $346.74 / $1,096.48	Professional		$199.53	$346.74	$1,096.48
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $181.97 / $676.08	Professional	26	$123.03	$181.97	$676.08
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $102.33 / $229.09	Professional	TC	$66.07	$102.33	$229.09
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 $251.19 / $251.19 / $269.15	Professional		$251.19	$251.19	$269.15
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $158.49 / $169.82	Professional	26	$144.54	$158.49	$169.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $91.20 / $102.33	Professional	TC	$87.10	$91.20	$102.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $51.29	Professional		$32.36	$33.11	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $295.12 / $446.68	Professional		$208.93	$295.12	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $169.82 / $263.03	Professional	26	$123.03	$169.82	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $120.23 / $186.21	Professional	TC	$87.10	$120.23	$186.21