Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.71 / $249.30 / $275.45	Facility	26	$158.71	$249.30	$275.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.78 / $266.39 / $464.68	Professional		$221.78	$266.39	$464.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.82 / $161.18 / $292.14	Professional	26	$138.82	$161.18	$292.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.73 / $100.38 / $150.41	Professional	TC	$81.73	$100.38	$150.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $221.97 / $228.50 / $280.04	Professional		$221.97	$228.50	$280.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $139.96 / $177.99 / $218.82	Professional	26	$139.96	$177.99	$218.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.46 / $260.05 / $345.92	Professional		$172.46	$260.05	$345.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $176.41 / $176.41 / $176.41	Facility	26	$176.41	$176.41	$176.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.47 / $343.57 / $545.52	Professional		$251.47	$343.57	$545.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $158.60 / $217.71 / $343.05	Professional	26	$158.60	$217.71	$343.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.86 / $132.00 / $219.91	Professional	TC	$92.86	$132.00	$219.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $237.16 / $359.98 / $1,052.76	Professional		$237.16	$359.98	$1,052.76
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $154.13 / $220.20 / $644.97	Professional	26	$154.13	$220.20	$644.97
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.31 / $118.80 / $220.00	Professional	TC	$81.31	$118.80	$220.00
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 $292.49 / $293.63 / $316.56	Professional		$292.49	$293.63	$316.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $171.84 / $187.93 / $202.16	Professional	26	$171.84	$187.93	$202.16
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.24 / $101.63 / $114.40	Professional	TC	$97.24	$101.63	$114.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $91.16 / $314.99	Professional		$32.34	$91.16	$314.99
United Facility/Professional Professional Modifier Low / Median / High Price $245.72 / $366.07 / $558.76	Professional		$245.72	$366.07	$558.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $147.77 / $212.85 / $335.21	Professional	26	$147.77	$212.85	$335.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.87 / $132.05 / $207.74	Professional	TC	$93.87	$132.05	$207.74