Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $295.12 / $323.59	Facility	26	$177.83	$295.12	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $346.74 / $1,096.48	Professional		$269.15	$346.74	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $218.78 / $676.08	Professional	26	$169.82	$218.78	$676.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $114.82 / $199.53	Professional	TC	$93.33	$114.82	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $288.40 / $524.81	Professional		$234.42	$288.40	$524.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $186.21 / $251.19	Professional	26	$165.96	$186.21	$251.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $309.03 / $407.38	Professional		$204.17	$309.03	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $398.11 / $616.60	Professional		$295.12	$398.11	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $251.19 / $398.11	Professional	26	$186.21	$251.19	$398.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $144.54 / $239.88	Professional	TC	$104.71	$144.54	$239.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $457.09 / $1,548.82	Professional		$269.15	$457.09	$1,548.82
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $257.04 / $1,000.00	Professional	26	$173.78	$257.04	$1,000.00
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $134.90 / $691.83	Professional	TC	$91.20	$134.90	$691.83
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 $338.84 / $346.74 / $371.54	Professional		$338.84	$346.74	$371.54
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $223.87 / $239.88	Professional	26	$204.17	$223.87	$239.88
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $117.49 / $131.83	Professional	TC	$112.20	$117.49	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $66.07	Professional		$32.36	$33.11	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $389.05 / $588.84	Professional		$281.84	$389.05	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $239.88 / $371.54	Professional	26	$173.78	$239.88	$371.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $147.91 / $223.87	Professional	TC	$104.71	$147.91	$223.87