Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.72 / $102.74 / $133.91	Facility	26	$60.72	$102.74	$133.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.50 / $325.00 / $527.00	Professional		$195.50	$325.00	$527.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $61.24 / $111.65	Professional	26	$52.78	$61.24	$111.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.16 / $237.52 / $392.04	Professional	TC	$138.16	$237.52	$392.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.60 / $147.34 / $147.34	Professional		$132.60	$147.34	$147.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.81 / $43.29 / $80.48	Professional	26	$41.81	$43.29	$80.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.62 / $208.44 / $440.21	Professional		$71.62	$208.44	$440.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.65 / $75.65 / $75.65	Facility	26	$75.65	$75.65	$75.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.54 / $325.22 / $570.89	Professional		$199.54	$325.22	$570.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.99 / $78.48 / $119.44	Professional	26	$47.99	$78.48	$119.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.18 / $236.33 / $462.85	Professional	TC	$139.18	$236.33	$462.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $224.05 / $346.82 / $1,579.45	Professional		$224.05	$346.82	$1,579.45
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.68 / $97.88 / $521.41	Professional	26	$68.68	$97.88	$521.41
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $159.86 / $250.76 / $1,223.77	Professional	TC	$159.86	$250.76	$1,223.77
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 $233.69 / $239.41 / $257.63	Professional		$233.69	$239.41	$257.63
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.30 / $70.69 / $74.40	Professional	26	$69.30	$70.69	$74.40
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.99 / $170.11 / $183.24	Professional	TC	$162.99	$170.11	$183.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $77.83 / $269.52	Professional		$32.34	$77.83	$269.52
United Facility/Professional Professional Modifier Low / Median / High Price $234.49 / $355.13 / $560.98	Professional		$234.49	$355.13	$560.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.74 / $82.48 / $151.22	Professional	26	$59.74	$82.48	$151.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.71 / $278.08 / $433.80	Professional	TC	$172.71	$278.08	$433.80