Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.14 / $107.40 / $118.50	Facility	26	$64.14	$107.40	$118.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.15 / $304.54 / $443.70	Professional		$185.15	$304.54	$443.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.02 / $66.63 / $117.18	Professional	26	$60.02	$66.63	$117.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.13 / $214.37 / $359.11	Professional	TC	$125.13	$214.37	$359.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.42 / $139.28 / $241.21	Professional		$111.42	$139.28	$241.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $58.89 / $60.17	Professional	26	$43.88	$58.89	$60.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $217.20 / $416.37	Professional		$75.31	$217.20	$416.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.37 / $87.37 / $87.37	Facility	26	$87.37	$87.37	$87.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.03 / $300.00 / $557.28	Professional		$187.03	$300.00	$557.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.21 / $84.24 / $130.50	Professional	26	$52.21	$84.24	$130.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.29 / $204.33 / $409.44	Professional	TC	$124.29	$204.33	$409.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $211.35 / $337.00 / $1,346.23	Professional		$211.35	$337.00	$1,346.23
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.20 / $102.71 / $528.63	Professional	26	$72.20	$102.71	$528.63
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.06 / $225.98 / $937.94	Professional	TC	$144.06	$225.98	$937.94
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 $221.04 / $225.55 / $243.39	Professional		$221.04	$225.55	$243.39
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.34 / $74.15 / $78.22	Professional	26	$72.34	$74.15	$78.22
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $146.88 / $153.21 / $165.17	Professional	TC	$146.88	$153.21	$165.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $81.83 / $254.62	Professional		$32.34	$81.83	$254.62
United Facility/Professional Professional Modifier Low / Median / High Price $204.87 / $330.86 / $514.57	Professional		$204.87	$330.86	$514.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.58 / $83.72 / $132.46	Professional	26	$64.58	$83.72	$132.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.29 / $236.27 / $407.62	Professional	TC	$140.29	$236.27	$407.62