Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $245.47 / $512.86	Facility		$32.36	$245.47	$512.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $11.22 / $26.30	Facility	26	$7.76	$11.22	$26.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.85 / $47.86 / $338.84	Facility	TC	$15.85	$47.86	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $30.90 / $109.65	Professional		$19.05	$30.90	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.55 / $38.90	Professional	26	$7.94	$9.55	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $18.20 / $36.31	Professional	TC	$10.72	$18.20	$36.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $19.05 / $23.99	Professional		$16.22	$19.05	$23.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.13 / $12.88	Professional	26	$6.46	$8.13	$12.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $18.62 / $21.88	Professional	TC	$12.02	$18.62	$21.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $107.15 / $199.53	Facility		$60.26	$107.15	$199.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $30.20 / $54.95	Professional		$10.96	$30.20	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $46.77 / $131.83	Facility		$16.98	$46.77	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $29.51 / $46.77	Professional		$19.50	$29.51	$46.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.02 / $17.78	Professional	26	$7.41	$12.02	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $17.38 / $30.90	Professional	TC	$11.22	$17.38	$30.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $56.23 / $151.36	Professional		$30.90	$56.23	$151.36
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $21.88 / $69.18	Professional	26	$10.47	$21.88	$69.18
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $24.55 / $61.66	Professional	TC	$18.62	$24.55	$61.66
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 $30.90 / $30.90 / $33.88	Professional		$30.90	$30.90	$33.88
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $10.72 / $11.48	Professional	26	$10.47	$10.72	$11.48
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $19.95 / $22.91	Professional	TC	$19.50	$19.95	$22.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $74.13 / $229.09	Facility		$11.75	$74.13	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.18 / $44.67	Professional		$19.95	$28.18	$44.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.96 / $16.60	Professional	26	$8.71	$10.96	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $16.60 / $28.18	Professional	TC	$10.96	$16.60	$28.18