Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.81 / $146.56 / $161.36	Facility	26	$86.81	$146.56	$161.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.82 / $282.20 / $469.76	Professional		$226.82	$282.20	$469.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.00 / $87.67 / $191.59	Professional	26	$73.00	$87.67	$191.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.84 / $191.62 / $310.30	Professional	TC	$147.84	$191.62	$310.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.27 / $82.09 / $107.54	Professional	26	$60.27	$82.09	$107.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.73 / $269.83 / $517.26	Professional		$102.73	$269.83	$517.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.01 / $102.01 / $102.01	Facility	26	$102.01	$102.01	$102.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.91 / $331.70 / $534.63	Professional		$222.91	$331.70	$534.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.77 / $110.82 / $171.23	Professional	26	$68.77	$110.82	$171.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.53 / $217.32 / $364.14	Professional	TC	$146.53	$217.32	$364.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $260.50 / $387.37 / $1,414.40	Professional		$260.50	$387.37	$1,414.40
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.25 / $140.44 / $557.11	Professional	26	$95.25	$140.44	$557.11
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $164.86 / $224.81 / $777.48	Professional	TC	$164.86	$224.81	$777.48
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 $274.60 / $279.81 / $301.55	Professional		$274.60	$279.81	$301.55
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $99.52 / $101.43 / $106.72	Professional	26	$99.52	$101.43	$106.72
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.61 / $173.17 / $194.83	Professional	TC	$165.61	$173.17	$194.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $111.64 / $315.47	Professional		$32.34	$111.64	$315.47
United Facility/Professional Professional Modifier Low / Median / High Price $252.99 / $343.93 / $505.98	Professional		$252.99	$343.93	$505.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.35 / $103.97 / $168.53	Professional	26	$83.35	$103.97	$168.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.44 / $242.89 / $333.65	Professional	TC	$163.44	$242.89	$333.65