Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $188.02 / $295.38 / $326.48	Facility	26	$188.02	$295.38	$326.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.14 / $307.47 / $537.78	Professional		$259.14	$307.47	$537.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $164.48 / $191.04 / $340.99	Professional	26	$164.48	$191.04	$340.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.36 / $113.86 / $166.32	Professional	TC	$91.36	$113.86	$166.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $262.16 / $364.11 / $479.88	Professional		$262.16	$364.11	$479.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $189.55 / $221.18 / $259.50	Professional	26	$189.55	$221.18	$259.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.42 / $308.35 / $404.71	Professional		$204.42	$308.35	$404.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.62 / $208.62 / $208.62	Facility	26	$208.62	$208.62	$208.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.44 / $401.66 / $646.08	Professional		$292.44	$401.66	$646.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $187.99 / $258.05 / $406.04	Professional	26	$187.99	$258.05	$406.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.85 / $150.87 / $245.40	Professional	TC	$102.85	$150.87	$245.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $277.86 / $421.54 / $1,526.46	Professional		$277.86	$421.54	$1,526.46
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $182.77 / $261.11 / $745.89	Professional	26	$182.77	$261.11	$745.89
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.13 / $136.77 / $561.73	Professional	TC	$96.13	$136.77	$561.73
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 $342.50 / $344.02 / $370.37	Professional		$342.50	$344.02	$370.37
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $203.67 / $223.02 / $239.62	Professional	26	$203.67	$223.02	$239.62
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $111.14 / $116.21 / $130.75	Professional	TC	$111.14	$116.21	$130.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $108.06 / $368.84	Professional		$32.34	$108.06	$368.84
United Facility/Professional Professional Modifier Low / Median / High Price $280.94 / $402.74 / $645.62	Professional		$280.94	$402.74	$645.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $175.25 / $249.26 / $397.11	Professional	26	$175.25	$249.26	$397.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.93 / $162.11 / $235.73	Professional	TC	$105.93	$162.11	$235.73