Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.04 / $59.75 / $59.75	Facility	26	$38.04	$59.75	$59.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.54 / $86.41 / $133.93	Professional		$68.54	$86.41	$133.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.72 / $38.04 / $58.96	Professional	26	$32.72	$38.04	$58.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.28 / $49.28 / $49.28	Professional	26	$49.28	$49.28	$49.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $82.57 / $131.88	Professional		$40.65	$82.57	$131.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.36 / $41.36 / $41.36	Facility	26	$41.36	$41.36	$41.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.65 / $112.25 / $177.93	Professional		$82.65	$112.25	$177.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.95 / $51.33 / $81.86	Professional	26	$37.95	$51.33	$81.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.91 / $125.09 / $289.91	Professional		$81.91	$125.09	$289.91
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.36 / $51.95 / $153.96	Professional	26	$36.36	$51.95	$153.96
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 $89.88 / $96.80 / $105.74	Professional		$89.88	$96.80	$105.74
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.52 / $44.36 / $47.67	Professional	26	$40.52	$44.36	$47.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $34.63 / $104.24	Professional		$32.34	$34.63	$104.24
United Facility/Professional Professional Modifier Low / Median / High Price $75.51 / $109.92 / $173.30	Professional		$75.51	$109.92	$173.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.26 / $50.93 / $83.23	Professional	26	$35.26	$50.93	$83.23