Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.79 / $209.64 / $229.84	Facility	26	$125.79	$209.64	$229.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.89 / $234.00 / $411.55	Professional		$195.89	$234.00	$411.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.08 / $138.21 / $286.87	Professional	26	$118.08	$138.21	$286.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.34 / $89.52 / $141.16	Professional	TC	$75.34	$89.52	$141.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $219.89 / $266.77 / $287.79	Professional		$219.89	$266.77	$287.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $133.47 / $169.88 / $189.29	Professional	26	$133.47	$169.88	$189.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.79 / $217.01 / $296.04	Professional		$143.79	$217.01	$296.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.65 / $147.65 / $147.65	Facility	26	$147.65	$147.65	$147.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.98 / $296.98 / $484.50	Professional		$214.98	$296.98	$484.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $133.44 / $181.52 / $288.66	Professional	26	$133.44	$181.52	$288.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.20 / $118.12 / $196.38	Professional	TC	$82.20	$118.12	$196.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $203.81 / $312.60 / $894.06	Professional		$203.81	$312.60	$894.06
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.63 / $183.75 / $513.89	Professional	26	$128.63	$183.75	$513.89
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.23 / $105.11 / $196.88	Professional	TC	$67.23	$105.11	$196.88
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 $250.34 / $252.33 / $270.92	Professional		$250.34	$252.33	$270.92
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $143.26 / $157.22 / $168.55	Professional	26	$143.26	$157.22	$168.55
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.02 / $91.09 / $102.38	Professional	TC	$87.02	$91.09	$102.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $75.95 / $269.60	Professional		$32.34	$75.95	$269.60
United Facility/Professional Professional Modifier Low / Median / High Price $210.71 / $303.69 / $486.05	Professional		$210.71	$303.69	$486.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.75 / $181.50 / $294.56	Professional	26	$123.75	$181.50	$294.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.05 / $133.04 / $206.92	Professional	TC	$87.05	$133.04	$206.92