Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.74 / $226.48 / $604.16	Facility		$41.74	$226.48	$604.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.98 / $13.09 / $21.23	Facility	26	$7.98	$13.09	$21.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $39.43 / $119.79	Facility	TC	$26.10	$39.43	$119.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.41 / $37.21 / $70.76	Professional		$30.41	$37.21	$70.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $12.41 / $61.39	Professional	26	$7.83	$12.41	$61.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.67 / $26.31 / $51.26	Professional	TC	$22.67	$26.31	$51.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.46 / $26.82 / $36.45	Professional		$21.46	$26.82	$36.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.60 / $12.39	Professional	26	$6.61	$10.60	$12.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $71.06 / $133.88 / $375.64	Facility		$71.06	$133.88	$375.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.05 / $39.44 / $80.02	Professional		$11.05	$39.44	$80.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.11 / $79.44 / $219.65	Facility		$40.11	$79.44	$219.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.83 / $48.99 / $74.02	Professional		$30.83	$48.99	$74.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $13.25 / $23.11	Professional	26	$7.86	$13.25	$23.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.51 / $35.01 / $51.34	Professional	TC	$21.51	$35.01	$51.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $41.67 / $61.69 / $159.11	Professional		$41.67	$61.69	$159.11
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $15.92 / $61.99	Professional	26	$10.60	$15.92	$61.99
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.83 / $43.34 / $97.12	Professional	TC	$28.83	$43.34	$97.12
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 Facility Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	TC	$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $42.48 / $43.26 / $47.18	Professional		$42.48	$43.26	$47.18
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.53 / $10.83 / $11.48	Professional	26	$10.53	$10.83	$11.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.64 / $32.72 / $35.70	Professional	TC	$31.64	$32.72	$35.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.01 / $32.34 / $49.35	Professional		$12.01	$32.34	$49.35
United Facility/Professional Facility Modifier Low / Median / High Price $159.43 / $249.41 / $407.87	Facility		$159.43	$249.41	$407.87
United Facility/Professional Professional Modifier Low / Median / High Price $34.47 / $44.40 / $69.51	Professional		$34.47	$44.40	$69.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $13.74 / $22.61	Professional	26	$10.16	$13.74	$22.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.80 / $32.04 / $49.85	Professional	TC	$23.80	$32.04	$49.85