Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.67 / $134.00 / $192.24	Facility	26	$81.67	$134.00	$192.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $307.47 / $475.00 / $952.08	Professional		$307.47	$475.00	$952.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.67 / $140.00 / $332.47	Professional	26	$81.67	$140.00	$332.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.76 / $335.00 / $485.52	Professional	TC	$252.76	$335.00	$485.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $187.00 / $227.60 / $283.33	Professional		$187.00	$227.60	$283.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.54 / $71.48 / $109.11	Professional	26	$56.54	$71.48	$109.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $165.74 / $165.74 / $165.74	Professional	TC	$165.74	$165.74	$165.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $363.94 / $697.67	Professional		$96.60	$363.94	$697.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.71 / $100.71 / $100.71	Facility	26	$100.71	$100.71	$100.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.08 / $491.53 / $875.41	Professional		$315.08	$491.53	$875.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.93 / $107.66 / $160.77	Professional	26	$64.93	$107.66	$160.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.96 / $371.11 / $738.76	Professional	TC	$234.96	$371.11	$738.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $346.59 / $551.39 / $2,387.17	Professional		$346.59	$551.39	$2,387.17
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.63 / $131.81 / $618.92	Professional	26	$92.63	$131.81	$618.92
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $269.89 / $423.36 / $1,900.98	Professional	TC	$269.89	$423.36	$1,900.98
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 $370.37 / $380.59 / $409.60	Professional		$370.37	$380.59	$409.60
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.24 / $95.20 / $100.35	Professional	26	$93.24	$95.20	$100.35
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.18 / $287.33 / $309.26	Professional	TC	$275.18	$287.33	$309.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $104.98 / $428.51	Professional		$32.34	$104.98	$428.51
United Facility/Professional Professional Modifier Low / Median / High Price $368.13 / $557.04 / $874.97	Professional		$368.13	$557.04	$874.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.81 / $101.24 / $158.44	Professional	26	$78.81	$101.24	$158.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $281.04 / $430.79 / $698.75	Professional	TC	$281.04	$430.79	$698.75