Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $162.18 / $162.18	Facility	26	$102.33	$162.18	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $281.84 / $478.63	Professional		$239.88	$281.84	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $102.33 / $165.96	Professional	26	$89.13	$102.33	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $181.97 / $354.81	Professional	TC	$144.54	$181.97	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $281.84 / $295.12	Professional		$251.19	$281.84	$295.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $251.19 / $446.68	Professional		$109.65	$251.19	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $380.19 / $660.69	Professional		$239.88	$380.19	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $138.04 / $218.78	Professional	26	$100.00	$138.04	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $245.47 / $457.09	Professional	TC	$123.03	$245.47	$457.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $416.87 / $724.44	Professional		$245.47	$416.87	$724.44
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $154.88 / $446.68	Professional	26	$100.00	$154.88	$446.68
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $239.88 / $398.11	Professional	TC	$93.33	$239.88	$398.11
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 $346.74 / $354.81 / $380.19	Professional		$346.74	$354.81	$380.19
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $128.82	Professional	26	$123.03	$123.03	$128.82
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $229.09 / $245.47	Professional	TC	$218.78	$229.09	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $331.13 / $537.03	Professional		$234.42	$331.13	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $125.89 / $204.17	Professional	26	$95.50	$125.89	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $208.93 / $354.81	Professional	TC	$131.83	$208.93	$354.81