Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $323.59 / $870.96	Facility		$64.57	$323.59	$870.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $63.10 / $74.13	Facility	26	$36.31	$63.10	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $100.00 / $426.58	Professional		$42.66	$100.00	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $60.26 / $169.82	Professional	26	$33.11	$60.26	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $39.81 / $190.55	Professional	TC	$25.12	$39.81	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.20 / $40.74	Professional		$25.12	$30.20	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $39.81 / $47.86	Professional	26	$29.51	$39.81	$47.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $199.53 / $707.95	Facility		$165.96	$199.53	$707.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $75.86 / $120.23	Professional		$43.65	$75.86	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $128.82 / $323.59	Professional		$72.44	$128.82	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $67.61 / $144.54	Professional	26	$39.81	$67.61	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $50.12 / $208.93	Professional	TC	$29.51	$50.12	$208.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $165.96 / $1,047.13	Professional		$66.07	$165.96	$1,047.13
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $89.13 / $562.34	Professional	26	$38.02	$89.13	$562.34
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $48.98 / $575.44	Professional	TC	$25.70	$48.98	$575.44
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
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 $77.62 / $77.62 / $85.11	Professional		$77.62	$77.62	$85.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $45.71 / $48.98	Professional	26	$43.65	$45.71	$48.98
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $33.11 / $36.31	Professional	TC	$32.36	$33.11	$36.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $51.29	Professional		$32.36	$33.11	$51.29
United Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $691.83 / $2,187.76	Facility		$131.83	$691.83	$2,187.76
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $138.04 / $302.00	Professional		$66.07	$138.04	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $72.44 / $120.23	Professional	26	$38.02	$72.44	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $57.54 / $190.55	Professional	TC	$28.18	$57.54	$190.55